Smoking is a more dangerous risk factor than metabolic syndrome in Egyptian patients with Acute Myocardial Infarction

ABSTRACT

Background: The effect of metabolic syndrome and other risk factors of myocardial infarction are not consistent in all studies. Aim: To assess the incidence of each risk factor in our community as a predictor of acute myocardial infarction.

Methods: Fifty patients (Pts) admitted to the main university hospital with acute MI were studied. All risk factors were recorded as well as echo measurements.  Inclusion criteria were: patients diagnosed as acute ST segment elevation myocardial infarction (STEMI) based on typical retrosternal chest pain associated with typical electrocardiographic changes of STEMI, with at least one cardiac enzyme assay result above twice the limit of normal. Incident cases of acute STEMI presenting within 24 h of symptoms onset were eligible. Metabolic Syndrome (MS) components were defined as detailed in the ATP III report: 1) waist circumference >102 cm in men and >88 cm in women, 2) fasting triglycerides ≥150 mg/dl. 3) HDL cholesterol <40 mg/dl in men and <50 mg/dl in women, 4) BP ≥130/85 mmHg, and 5) fasting - glucose ≥ 110 mg/dl. Participants with at least three of these components were determined to have the MS.

Results: MS was present in 27 pts (54%) The incidence of different risk factors in the 50 pts: Family history of any point (before age 60) as coronary disease, sudden death, diabetes, Ht was present in 36 pts (72%), smoking (current or stopped less than 6 months 38 pts (76%). 60 % had diabetes.

Conclusions: Comparing to incidence in Egypt: Diabetes in infarcted patients was 5 (6) times more. Smoking was twice more, metabolic s. was twice more; HT was twice more (48%). We highlight the danger of diabetes and smoking as the most significant predictors of MI in Egyptian population.

Key words:  Metabolic syndrome, risk factors, acute ST segment elevation myocardial infarction

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