The Usefulness of the Metabolic Syndrome Score in Predicting the Angiographic Outcome in Patients With STEMI Treated With Primary Percutaneous Coronary Intervention

The relationship between metabolic syndrome (MS) and the MS score and the angiographic outcome of primary percutaneous coronary intervention (PPCI) for ST-segment-elevation myocardial infarction (STEMI) is still unclear. We aimed to examine the association between angiographic outcomes including angiographic no-reflow and MS.

We prospectively included 100 patients with STEMI treated with PPCI. Angiographic no-reflow was defined as a thrombolysis in myocardial infarction (TIMI) risk score of below 3 or a TIMI risk score of 3 with a myocardial blushing grade (MBG) of 0 to 1 in the absence of mechanical complications. MS was defined based on the National Cholesterol Education Program criteria. The MS score was defined as the number of MS components present.

Totally, 26 patients (26%) developed no-reflow. The patients with no-reflow had a higher prevalence of MS, a higher level of triglycerides, a lower level of high-density lipoprotein, and a higher fasting blood glucose level. The fasting blood glucose level and the time from symptom onset to wire crossing were independent predictors of the no-reflow phenomenon (OR, 1.225; 95% CI, 1.105 to 2.854; P<0.001) and (OR, 1.049; 95% CI, 1.026 to 1.073; P<0.001).
There were significant negative correlations between the MS score and both the post-intervention TIMI flow grade and MBG (P<0.001 for both).

MS plays an important role in the development of no-reflow in STEMI patients treated with PPCI with significant negative correlations between the MS score and both the post-intervention TIMI flow grade and MBG. (Iranian Heart Journal 2021; 22(4): 80-89)