| Prevalencia del síndrome metabólico y sus componentes en pacientes con síndrome coronario agudo |
Prevalence of Metabolic Syndrome and its Components in Patients With Acute Coronary Syndrome.
Jover A, Corbella E, Muñoz A, Millán J, Pintó X, Mangas A, Zúñiga M, Pedro-Botet J, Hernández-Mijares A.
Servicio de Endocrinología, Hospital Universitario Dr. Peset y Fundación para la Investigación Hospital Universitario Dr. Peset, Valencia, España.
Rev Esp Cardiol. 2011 Jul;64(7):579-586. Epub 2011 Jun 2.
Abstract
INTRODUCTION AND OBJECTIVES: A large proportion of patients with coronary disease have metabolic syndrome, although the frequency and association of its different components are not well understood. The aim of this study was to determine the prevalence of metabolic syndrome and the combination of its components in a Spanish cohort of patients with acute coronary syndrome. METHODS: Clinical histories of 574 inpatients with acute coronary syndrome in 6 tertiary hospitals were reviewed and the presence of metabolic syndrome and its components determined by applying Adult Treatment Panel III criteria. In a second step, the components of the metabolic syndrome were analyzed, excluding those patients with diabetes mellitus. RESULTS: The metabolic syndrome was present in 50.9% of patients and was more frequent in women than in men (66.3% vs. 47.3%; P<.001). The most prevalent component was carbohydrate metabolism disorder (85.3%), followed by low high-density lipoprotein cholesterol (HDLc) levels (80.5%). In nondiabetic patients, 34.6% had metabolic syndrome and the most prevalent component was low HDLc levels (86%), followed by high blood pressure and hypertriglyceridemia and, in fourth place, impaired fasting serum glucose levels. CONCLUSIONS: The metabolic syndrome has a high prevalence in patients with an acute coronary syndrome, especially in women. The most frequent components are hyperglycemia and low HDLc levels. After excluding diabetic patients, the most prevalent diagnostic criterion of metabolic syndrome was low HDLc levels. Full English text available from:www.revespcardiol.org.
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| Síndrome metabólico y resistencia a la insulina: consideraciones perioperatorias |
Metabolic syndrome and insulin resistance: perioperative considerations.
Bagry HS, Raghavendran S, Carli F.
Department of Anesthesia, McGill University Health Centre, Montreal, Canada.
Anesthesiology. 2008 Mar;108(3):506-23.
Abstract
Metabolic syndrome represents a constellation of risk factors associated with increased incidence of cardiovascular disease and progression to diabetes mellitus. Insulin resistance, a state of decreased biologic response to physiologic concentrations of insulin, is a key component of this syndrome and seems to be the result of a primary defect at the skeletal muscle glucose transporter. Acute illness and the perioperative period are characterized by a state of insulin resistance that manifests as hyperglycemia and leads to various other metabolic and biochemical alterations that adversely affect end organ function. Hyperglycemia in acutely ill patients adversely affects outcome. Achieving euglycemia seems beneficial in certain clinical situations, but considerable disagreement exists regarding the target blood sugar levels, the duration of therapy, and the modality. Pharmacotherapy, exercise, and nutrition to improve insulin sensitivity seem promising but require further evaluation to confirm their efficacy for perioperative risk reduction. This review discusses the pathophysiology and the clinical implications of metabolic syndrome and insulin resistance in the acutely ill patient with an emphasis on perioperative modulation strategies
http://journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=2008&issue=03000&article=00023&type=abstract
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| Características diferenciales de pacientes con síndrome coronario agudo con elevación del segmento ST comparado con aquellos con elevación transitoria del segmento ST |
Differential characteristics of patients with acute coronary syndrome without ST-segment elevation compared to those with transient ST-segment elevation.
Arroyo Úcar E, Domínguez-Rodríguez A, Juárez Prera R, Blanco Palacios G, Hernández García C, Carrillo-Pérez Tome M, Abreu-González P.
Servicio de Cardiología, Hospital Universitario de Canarias, Tenerife, España.
Med Intensiva. 2011 Jun-Jul;35(5):270-3. Epub 2011 Feb 24.Abstract
OBJECTIVE: To evaluate different characteristics of patients with acute coronary syndrome (ACS) without ST-segment elevation compared with transient St-segment elevation.DESIGN:
An observational, prospective study. SETTING: A 12-bed coronary care unit. PATIENTS:
Consecutive patients of ACS without persistent ST-segment elevation. MAIN VARIABLES OF INTEREST: The population was divided intro 2 groups according to the presence of transient ST-segment elevation. Variables of interest were age, cardiovascular risk factors, troponin I and glucose concentrations on admission, coronary anatomy, left ventricular ejection fraction, inhospital mortality and drugs. RESULTS: Patients identified as ACS with transient ST-segment elevation were significantly younger, smokers and predominantly male. At the same time, they showed a minor peak elevation of troponin I, a higher ejection fraction and, mainly single-vessel coronary disease. CONCLUSIONS: Patients with ACS with transient ST-segment elevation differ in the type of population, myocardial damage and coronary angiographic results with respect to patients with ACS without ST-segment elevation. More research is needed to clarify whether these differences imply a different therapeutic approach.
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