The Usefulness of the Metabolic Syndrome Score in Predicting the Angiographic Outcome in Patients With STEMI Treated With Primary Percutaneous Coronary Intervention

Background: The relationship between metabolic syndrome (MS) and the MS score and the angiographic outcome of primary percutaneous coronary intervention (PPCI) for ST-segment-elevation myocardial infarction (STEMI) is still unclear. We aimed to examine the association between angiographic outcomes including angiographic no-reflow and MS.   Methods: We prospectively included 100 patients with STEMI treated with PPCI. Angiographic no-reflow was defined as a thrombolysis in myocardial infarction (TIMI) risk score of below 3 or a TIMI risk score of 3 with a myocardial blushing grade (MBG) of 0 to 1 in the absence of mechanical complications. MS was defined based on the National Cholesterol Education Program criteria. The MS score was defined as the number of MS components present.   Results: Totally, 26 patients (26%) developed no-reflow. The patients with no-reflow had a higher prevalence of MS, a higher level of triglycerides, a lower level of high-density lipoprotein, and a higher fasting blood glucose level. The fasting blood glucose level and the time from symptom onset to wire crossing were independent predictors of the no-reflow phenomenon (OR, 1.225; 95% CI, 1.105 to 2.854; P<0.001) and (OR, 1.049; 95% CI, 1.026 to 1.073; P<0.001). There were significant negative correlations between the MS score and both the post-intervention TIMI flow grade and MBG (P<0.001 for both).   Conclusions: MS plays an important role in the development of no-reflow in STEMI patients treated with PPCI with significant negative correlations between the MS score and both the post-intervention TIMI flow grade and MBG. (Iranian Heart Journal 2021; 22(4): 80-89)