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INFLUENCE OF ANTHROPOMETRIC PARAMETERS AND METABOLIC SYNDROME ON CLINICAL SEVERITY AND PROGNOSIS OF ACUTE ST-ELEVATION MYOCARDIAL INFARCTION (CROSBI ID 402242)

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Mornar Jelavic Marko INFLUENCE OF ANTHROPOMETRIC PARAMETERS AND METABOLIC SYNDROME ON CLINICAL SEVERITY AND PROGNOSIS OF ACUTE ST-ELEVATION MYOCARDIAL INFARCTION / Prof.dr.sc. Hrvoje Pintaric, dr.med. (mentor); Doc.dr.sc. Zdravko Babic, dr.med. (neposredni voditelj). Zagreb, Stomatološki fakultet, . 2015

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Mornar Jelavic Marko

Prof.dr.sc. Hrvoje Pintaric, dr.med.

Doc.dr.sc. Zdravko Babic, dr.med.

engleski

INFLUENCE OF ANTHROPOMETRIC PARAMETERS AND METABOLIC SYNDROME ON CLINICAL SEVERITY AND PROGNOSIS OF ACUTE ST-ELEVATION MYOCARDIAL INFARCTION

Objective: Investigation the influence of metabolic syndrome (MetS) and anthropometric parameters on clinical severity and prognosis in patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). Patients and Methods: We prospectively analysed 250 patients with acute STEMI treated with primary PCI, between September 2011-2012, in Department for Cardiovascular Diseases, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia. MetS was diagnosed by the revised National Cholesterol Education Program Adult Treatment Panel III criteria. Patients were divided in two groups (with/without MetS) which were compared by their baseline (medical history, demographic) and parameters of severity (clinical, laboratory, echocardiography, coronary angiography and in-hospital complications data) and prognosis (major adverse cardiovascular events (MACE) (reinfarction, coronary arteries restenosis and/or new stenosis, cardiac and/or non-cardiac rehospitalization, cerebrovascular insult, urgent coronary artery bypass graft, mortality, and total MACE) and sick leave duration during 12 months follow-up period). Additionally, patients were divided according to the anthropometric parameters in three groups as follows: body mass index (BMI) (<25.0, 25.0-29.9 and ≥30.0 kg/m²), waist circumference (WC) (<102/88 and ≥102/88 cm for males/females) and waist-to-hip ratio (WHR) (<0.90/0.85 and ≥0.90/0.85 for males/females). They were analysed and compared by the same baseline and parameters of severity and prognosis. Results: There were 136 (54.4%) and 114 (45.6%) patients with and without MetS, respectively. MetS patients had longer hospitalization (9.0 vs. 8.0 days), higher rates of total in-hospital complications (47.8% vs. 34.2%), higher number of significant stenosed coronary arteries (2 vs. 1), wider stents diameter (3.5 vs. 3.0 mm), higher rate of significant stenosed proximal/middle coronary arteries segments (94.1% vs. 86.7%), and longer sick leave duration (16 vs. 10 weeks) (p<0.05). MetS was independently associated with higher risk of total in-hospital complications (Odds ratio (OR) 1.76, Confidence interval (CI) [1.05-2.94], p=0.031) and with higher risk of ≥2 significant stenosed coronary arteries (OR 1.72, CI [1.04-2.84], p=0.034). Among the same 250 patients, there were 72 (28.8%), 149 (59.6%) and 222 (88.8%) patients with BMI ≥30.0 kg/m², WC ≥102/88 cm and WHR ≥0.90/0.85, respectively. Patients with BMI <25.0 kg/m² had highest rates of dyspnea, those with BMI ≥30.0 kg/m2 had longer hospitalization and wider diameter of stents, and those with WHR ≥0.85/0.90 had higher rates of significant stenosed proximal/middle coronary arteries segments (p<0.05). BMI <25.0 kg/m2 was independently associated with higher (OR 2.0, CI [1.10-3.67], p=0.025) and BMI 25.0-29.9 kg/m2 with lower risk of dyspnea (OR 0.51, CI [0.29-0.90], p=0.020). Finally, number of significantly stenosed coronary arteries was independently associated with total MACE (OR 1.79, CI [1.17-2.77], p=0.008). Conclusion: MetS in acute STEMI is an independent predictor of total in-hospital complications and severity of coronary arteries disease, but not for other parameters of severity and prognosis. BMI is an independent predictor for some components of severity (but not prognosis) in acute STEMI, while WC and WHR seems to be inferior in that prediction with no impact on both severity and prognosis in these patients.

Metabolic syndrome ; anthropometry ; myocardial infarction.

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Podaci o izdanju

149

23.09.2015.

obranjeno

Podaci o ustanovi koja je dodijelila akademski stupanj

Stomatološki fakultet

Zagreb

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