Impact of metabolic syndrome in patients with acute coronary syndrome.

The reported incidence of metabolic syndrome among patients with an acute coronary syndrome varies between 29 and 46%. The standard fasting cut-off levels for glucose and blood pressure cannot be applied on admission in patients with acute coronary syndrome and therefore modified criteria were used to define the metabolic syndrome. Patients with metabolic syndrome and acute coronary syndrome had increased incidence of heart failure, and worse long-term mortality compared to those without metabolic syndrome. However, they had less heart failure than those with known diabetes mellitus. Hyperglycemia as a risk factor for poor outcome is particularly significant in patients with metabolic syndrome. De novo identification of the metabolic syndrome on admission has the potential to improve risk stratification and management of patients with an acute coronary syndrome.