Madrid-Miller A, Alcaraz-Ruiz A, Borrayo-Sánchez G, Almeida-Gutiérrez E, Vargas-Guzmán RM, Jáuregui-Aguilar R

Idioma: Español
Referencias bibliográficas: 28
Paginas: 115-123
Archivo PDF: 394.22 Kb.

RESUMEN

Introducción: El síndrome metabólico agrupa diferentes factores de riesgo y es uno de los principales problemas de salud pública del siglo XXI. El objetivo de este estudio fue establecer su repercusión en pacientes con síndrome coronario agudo (SICA).
Material y métodos: Se incluyeron pacientes con SICA, con y sin elevación del segmento ST. Se formaron dos grupos: A, pacientes que reunían los criterios para síndrome metabólico; B, pacientes sin criterios para síndrome metabólico. Se comparó la incidencia de eventos cardiovasculares mayores, severidad de la enfermedad coronaria, necesidad de revascularización y mortalidad intrahospitalaria.
Resultados: De 971 pacientes con SICA, 421 (43.4%) tuvieron síndrome metabólico. La edad fue de 63.37 ± 9.95 años versus 61.77 ± 12.2 años; 66.7% versus 72.8% hombres; 70.3% versus 33.3% diabéticos; 87.6% versus 40.5% hipertensos y dislipidemia 70.5% versus 26.9%, respectivamente para los grupos A y B. El diagnóstico de SICA con elevación del ST fue más frecuente en el grupo A, así como mayor severidad en el grado de enfermedad arterial coronaria y mayor incidencia de eventos cardiovasculares mayores. En el análisis multivariado se encontró que la hiperfibrinogenemia, la hiperglucemia y el síndrome metabólico, eran predictores independientes de insuficiencia cardiaca y puntos finales combinados.
Conclusiones: La frecuencia de síndrome metabólico en pacientes con SICA es alta, con mayor comorbilidad y edad, lo que se asocia con peor pronóstico intrahospitalario. Probablemente la respuesta inflamatoria y protrombótica, aunada a mayor severidad de la enfermedad arterial coronaria de estos pacientes, sea la que incrementa la incidencia de eventos cardiovasculares.

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