A study on association between metabolic syndrome and acute coronary syndrome

Sangeetha, G (2018) A study on association between metabolic syndrome and acute coronary syndrome. Masters thesis, Thanjavur Medical College, Thanjavur.


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INTRODUCTION: The metabolic syndrome (syndrome X, insulin resistance syndrome) consists of a group of metabolic abnormalities that confer increased risk of cardiovascular disease (CVD) and diabetes mellitus. Evolution of the criteria for the metabolic syndrome since the original definition by the World Health Organization (WHO) in 1998 reflects growing clinical evidence and analysis by a variety of consensus conferences and professional organizations that led to the increasing understanding of this syndrome. The major features of the metabolic syndrome include central obesity, hyper triglyceridemia, low levels of high-density lipoprotein (HDL) cholesterol, hyperglycemia, and hypertension. AIMS AND OBJECTIVE: 1. To study the association between metabolic syndrome and acute coronary syndrome 2. To study the prevalance of metabolic syndrome in acute coronary syndrome. METHODOLOGY: Study Design: Prospective Study. Study Period: March 2017 To August 2017. STUDY POPULATION: About 50 Patients admitted in ICCU. Inclusion Criteria: 1. Patients with Acute STEMI, NON STEMI, UNSTABLE ANGINA, 2. Both males and female. Exclusion Criteria: 1. Age less than 18 years, 2. Known coronary artery disease patient, 3. Patients refusal to participate, 4. Patients with hypothyroidism, 5. Patients with familial hypercholesterolemia. Study Place: Thanjavur Medical College & Hospital, Thanjavur. DISCUSSION: 50 proven cases of acute coronary syndrome who were admitted to the cardiac intensive care unit were selected for analyzing the prevalence of metabolic syndrome. All of them satisfied the inclusion criteria. All patients were subjected to the detailed clinical history and examination. BP was recorded from all patients.12 lead ECG was done whenever indicated. ECHO was done for all patients. Abdominal circumference of all patients were measured in standing position at a point midway between lower most point of costal margin and upper most point of iliac crest. In a few moribund patients who could not stand, measurement was taken in supine position. Blood samples were taken for analysis of fasting blood sugar, urea, creatinine and electrolytes on the first day and for fasting blood sugar and lipid profile on the morning of day 3. In our study the 12 patients who satisfied the criteria for metabolic syndrome were taken as study subjects and the remaining 38 patients who had no jmetabolic syndrome served as the control group. CONCLUSION: The prevalence of MS was 76% (76.3% male and 75% female) with IDF-criteria. Number of male patients was higher in the above group. Our study not aimed at a particular population or age group, the bulk of patients found between 41 to 70 years age group. Out of these 50 patients we found the more common presentation of ACS was STEMI (80%)followed by the NSTEMI (6%) and unstable angina (UA) (4%) . There was no significant difference in prevalence of presenting symptoms. In MS group of patients STEMI presentation was 83.3% followed by NSTEMI (8.3%) and UA (8.3%). In NMS group STEMI was present in 92.1% followed by the NSTEMI (5.3%) and UA (2.6%). Waist circumference of more than 90 cms in male and > 80 cms in female was prevalent in 100% of the metabolic syndrome group and it showed statistical significance (p=0.0001). Fasting glucose was elevated to the extent of 50% in the metabolic syndrome group and it was statistically significant (p= 0.024). Triglycerides was elevated to 50% in the metabolic syndrome group and this also showed to be statistically significant P <0.0004. The total cholesterol were increased in both the groups and there was no significance in both the groups. Though smoking and alcohol was more prevalent in the non-metabolic syndrome group this was not significant statistically. Among 50 patients studied for the prevalence of metabolic syndrome in patients with acute coronary syndrome the overall prevalence was 76% . Triglycerides and blood pressure and waist circumference highly influenced the occurrence of metabolic syndrome. Metabolic syndrome is associated with increased risk of devoleping CVD 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: association ; metabolic syndrome ; acute coronary syndrome.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 08 Sep 2018 13:31
Last Modified: 11 Sep 2018 02:13
URI: http://repository-tnmgrmu.ac.in/id/eprint/9431

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