Effect of the Metabolic Syndrome on Outcomes in Patients Aged <50 Years Versus >50 Years With Acute Myocardial Infarction

The presence of metabolic syndrome (MS) is associated with an increased risk of cardiovascular disease morbidity and mortality. Moreover, data are lacking on the association of MS with clinical outcomes in young adults with acute myocardial infarction (AMI). This study was a retrospective analysis of 2,082 patients with AMI who underwent percutaneous coronary intervention. The term young was defined as age <50 years. The prevalence of patients aged <50 years was 18.4%. Among those patients, 43.4% had MS. The highest incidence of long-term major adverse cardiac and cerebral events was in old patients without MS (30.7% in young patients with MS, 22.2% in young patients without MS, 38.4% in old patients with MS, and 40.4% in old patients without MS, p <0.001). However, recurrent AMI (re-AMI) was the highest in young AMI patients with MS (4.8%, 1.4%, 2.1%, and 1.5%, p = 0.035, respectively). In Kaplan-Meier curve, young AMI patients with MS tend to have highest incidence of re-AMI (p = 0.050). The presence of MS in young AMI patients was an independent predictor of 6-year major adverse cardiac and cerebral events (hazard ratio 3.320, 95% confidence interval 1.073 to 10.283, p = 0.038) and re-AMI (hazard ratio 7.782, 95% confidence interval 1.290 to 45.298, p = 0.022). In conclusion, almost half of young patients with AMI had MS. The young AMI patients with MS had the highest incidence of re-AMI compared with the other groups. Aggressive pharmacological intervention and lifestyle modification are needed for the management of AMI in young patients with MS.