A Study Prevalence of Metabolic Syndrome in Patients with Acute Coronary Syndrome

Meenakshi, A (2011) A Study Prevalence of Metabolic Syndrome in Patients with Acute Coronary Syndrome. Masters thesis, Stanley Medical College, Chennai.

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Abstract

INTRODUCTION: Metabolic syndrome is one of the health issues of this century. It is a constellation of physical conditions and metabolic abnormalities commonly occurring together, that increases the individuals risk for the development of type 2 diabetes mellitus and cardiovascular disease. If the current trend continues the premature deaths and disabilities resulting from these conditions will increase the financial burden in developed and developing countries. As the prevalence of metabolic syndrome is high worldwide and increasing day by day due to sedentary lifestyle the findings of the present study has important implications for clinical practice emphasis must be placed on the intake of balanced diet and the control of lipid level particularly that of triglycerides. AIM OF THE STUDY: To ascertain the prevalence of metabolic syndrome in patients with acute coronary syndrome and to find out the association of each component of metabolic syndrome with acute coronary syndrome. MATERIALS AND METHODS: BACKGROUND: Metabolic syndrome consist of a cluster of metabolic and haemodynamic disorders that promote the development of atherosclerosis. The presence of metabolic syndrome has been positively correlated with cardiovascular risk. The prevalence of metabolic syndrome was assessed using NCEP III. Study Design: Prospective non randomized case series. Study Population: About 100 patients admitted in intrinsic coronary care unit. Inclusion Criteria: All patients with STEMI,NSTEMI and unstable angina. Exclusion Criteria: Patients with preexisting valvular heart disease was excluded from the study. METHODOLOGY: Patients with unstable angina, STEMI and NSTEMI were evaluated for metabolic syndrome using NCEP ATPIII guidelines. Waist circumference was measured at the narrowest point with stomach relaxed. Blood samples were collected for fasting blood sugar with overnight fasting. Blood samples were collected for lipid profile with 12 hours overnight fasting. Blood pressure was recorded in right upper limb in sitting posture. RESULTS: The study was done in 70 males and 30 females . There was a sex predilection in females when compared to males. p value was calculated using chi square test it was not significant. Fasting blood sugar values were compared in both patients with metabolic syndrome and with no metabolic syndrome. Out of 33 patients with metabolic syndrome all 33 had elevated blood sugar values greater than 100 mgs%.In non metabolic syndrome group 44 patients had elevated blood sugar out of 67 patients.the percentage was 100% in patients with metabolic syndrome when compared with 65% in patients without metabolic syndrome it revealed a significant p value. Blood pressure was elevated more than the cut off value in 26 patients out of 33 patients with metabolic syndrome.17 patients out 67 had elevated blood pressure in patients without metabolic syndrome. The difference between the two groups were 78% in patients with metabolic syndrome and 25% in patients without metabolic syndrome. p value revealed a significant value. Out of the 100 patients 21 patients had elevated triglyceride levels among 33 patients with metabolic syndrome and 8 patients with no metabolic syndrome among 67 patients. The difference between the two groups were 63%versus 13%In patients without metabolic syndrome. p value was significant. Out of 100 patients studied with metabolic syndrome 33patients had HDL levels lesser than 50 mgs%. in patients without metabolic syndrome 45 patients had HDL levels lesser than50 mgs%. Patients with metabolic syndrome showed100% when compared with 65% in patients without metabolic syndrome. Waist circumference was increased in 22 out of 33 patients with metabolic syndrome when compared to 60 out of 67 in patients without metabolic syndrome. Waist circumference in patients with metabolic syndrome was 66% when compared to 89% in patients without metabolic syndrome. p value was significant and was less than 0.001. The components highly influencing the occurrence of metabolic syndrome was studied by applying logistic regression method. Out of the 100 patients studied triglycerides and blood pressure were the two variables that were statiscally significant highly influencing the occurrence of metabolic syndrome. Out of the 100 patients studied in patients with metabolic syndrome all had elevated blood sugar values contributing to 100%. 26 patients had high blood pressure out of 33 contributing to 78%.21 patients had elevated triglycerides out of 33 contributing to 63%.all 33 patients had low HDL levels yielding 100%.22 patients had increased waist circumference out of 33 patients contributing 66%. All patients showed statiscal significance confirming strong association with metabolic syndrome. CONCLUSION: Among 100 patients studied for the prevalence of metabolic syndrome in patients with acute coronary syndrome the overall prevalence was 33%. There was predilection in females when compared to males. Triglycerides and blood pressure highly influenced the occurrence of metabolic syndrome. All patients showed statistical significance confirming strong association with acute coronary syndrome. It was also associated with increased risk of recurrent myocardial infarction. Metabolic syndrome is associated with higher risk characteristics and increased risk for the development of heart failure without increase in hospital mortality. So to prevent the complications due to metabolic syndrome there is a need for early and intensive preventive measures.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Prevalence ; Metabolic Syndrome ; Patients ; Acute Coronary Syndrome.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 23 Mar 2018 18:00
Last Modified: 24 Mar 2018 16:20
URI: http://repository-tnmgrmu.ac.in/id/eprint/6533

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