Prevalence of metabolic syndrome in young patients with acute MI: does the Framingham Risk Score underestimate cardiovascular risk in this population?

To assess the prevalence of metabolic syndrome (MS) and estimates of global risk by Framingham Risk Score in young subjects with acute myocardial infarction (MI), we assessed metabolic parameters and global risk assessment in 165 consecutive subjects who presented with myocardial infarction prior to 45 years of age. Nearly 80% of subjects were overweight or obese and at least one cardiovascular risk factor was present in 96% of patients. MS with or without overt diabetes was present in nearly two thirds of subjects. Excluding subjects with diabetes, the mean 10-year Framingham Risk Score estimate in the total cohort was 9.3%, with only 17.1% of subjects having a 10-year risk greater than 20%. Only 28% of subjects with MS had a Framingham Risk Score greater than 20%. Although MS is present in nearly two thirds of young patients with premature myocardial infarction, the Framingham Risk Score appears to underestimate global cardiovascular risk in this population.