Archives of the Turkish Society of Cardiology
The relationship between metabolic syndrome and TIMI risk score in nondiabetic patients with acute coronary syndrome [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2007; 35(4): 231-236

The relationship between metabolic syndrome and TIMI risk score in nondiabetic patients with acute coronary syndrome

Zekeriya Nurkalem, Ahmet Lütfü Orhan, Ahmet Taha Alper, Nevzat Uslu, Hüseyin Aksu, Muhammed Gürdoğan, İrfan Şahin, Betül Erer, Şevket Görgülü, Mehmet Eren
Siyami Ersek Thoracic And Cardiovascular Surgery Center, Cardiology Department - Istanbul


OBJECTIVES
We compared fasting and postprandial glycemia levels and their correlation with the TIMI risk score in nondiabetic patients with metabolic syndrome (MS).

STUDY DESIGN
The study included 73 consecutive nondiabetic patients (9 women, 64 men; mean age 58±11 years) who were admitted with unstable angina pectoris and acute myocardial infarction without ST elevation. TIMI risk scores were calculated on admission and coronary angiographies were evaluated. Prior to discharge, fasting glucose levels and lipid parameters were estimated and oral glucose tolerance test (OGTT) was performed. The presence of metabolic syndrome was determined in two ways: first using the ATP III criteria, and then using the same criteria, but with impaired glucose tolerance (GT) instead of impaired fasting glucose.

RESULTS
According to the ATP III criteria, MS was diagnosed in 30 patients (41.1%). The mean TIMI risk score in these patients was higher than that of patients without MS, but this did not reach a significant level (p=0.052). When impaired GT was included into the MS criteria instead of impaired fasting glucose, the number of patients with MS increased to 34 (46.6%), at which time the mean TIMI risk score showed a significant rise in the MS group (p=0.017). In multivariate analysis, the number of stenotic vessels (OR 3.02, p=0.02, 95% CI: 1.91-7.64) and postprandial glucose level (OR 1.040, p<0.001, 95% CI: 1.018-1.063) were found as independent predictors of a high TIMI risk score.

CONCLUSION
The incidence of MS is considerable in nondiabetic patients with acute coronary syndrome. The use of impaired GT instead of fasting glucose for the diagnosis of MS results in a better correlation with the TIMI risk score.

Keywords: Blood glucose, coronary disease, glucose intolerance, glucose tolerance test; metabolic syndrome X; risk assessment

How to cite this article
Zekeriya Nurkalem, Ahmet Lütfü Orhan, Ahmet Taha Alper, Nevzat Uslu, Hüseyin Aksu, Muhammed Gürdoğan, İrfan Şahin, Betül Erer, Şevket Görgülü, Mehmet Eren. The relationship between metabolic syndrome and TIMI risk score in nondiabetic patients with acute coronary syndrome. Turk Kardiyol Dern Ars. 2007; 35(4): 231-236

Corresponding Author: Zekeriya Nurkalem, Türkiye
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