Metabolic Syndrome Among Patients with Coronary Syndrome

Section: Research Paper
Issue
Vol. 47 No. 2 (2025): Volume 47 Issue 2
Published
Dec 29, 2025
Pages
221-229

Abstract

Background: Metabolic syndrome is a complex of heart disease and type two diabetes mellitus. Its diagnostic criteria vary between organizations such as American Diabetes Association (ADA) and World Health Organization (WHO). Lifestyle modifications are the cornerstone of its management.


Objective: The primary aim is to detect frequency of metabolic syndrome in patients diagnosed with coronary heart diseases.


Methods: Case series descriptive study.  Patients who had acute coronary syndromes are qualified to be admitted to the cardiac care unit of Ibn-Sena Teaching Hospital. The individuals ranged in age from 17 to 88 years. The study conducted between March 1st, 2023 and September 1st, 2023. The study includs 61 patients (40 males and 21 females). Data were gathered and analyzed with Google Sheets and JASP 0.17.3 featured 18 variables (9 continuous and 9 categorical). Analysis performed by using and Fisher's, Chi-Square and Mann-Whitney U test.


Results: In this study, (73.8%) of study patients had metabolic syndrome. Individuals aged 50 to 65 years had the highest frequency of metabolic syndrome cases, accounting for 60% of all patients diagnosed with metabolic syndrome. The frequency of metabolic syndrome in patients with acute coronary syndrome was lower in males than in females. Among ACS patients with metabolic syndrome, 51.1% were unemployed and 48.9% employed, indicating no significant association between employment status and the presence of metabolic syndrome (p = 0.613). It has been found that the highest prevalence of metabolic syndrome (60%) among ACS patients aged 50–65. In contrast, other age groups under 35, 35–50, 65–80, and over 80 had more patients without metabolic syndrome, indicating an age-specific distribution pattern.


Conclusion: Metabolic syndrome was highly prevalent (73.8%) among ACS patients, reflecting global patterns and highlighting key demographic influences. These findings stress the need for early, person-centered prevention of cardiovascular risk.

References

  1. Thygesen K, Alpert JS, Jaffe AS, et al. Fourth Universal Definition of Myocardial Infarction (2018). J Am Coll Cardiol. 2018 Oct 30;72(18):2231-64.
  2. Libby P. Mechanisms of acute coronary syndromes and their implications for therapy. N Engl J Med. 2013 May 23;368(21):2004-13.
  3. Roth GA, Mensah GA, Johnson CO, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol. 2020 Dec 22;76(25):2982-3021.
  4. Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute Coronary Syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014 Dec 23;64(24):e139-e228.
  5. Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018 Jan 7;39(2):119- 77.
  6. Grundy SM, Hansen B, Smith SC, et al. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Arterioscler Thromb Vasc Biol. 2004 Feb;24(2):e19-24.
  7. Kaur R, Kaur M. Evaluation of potential association of metabolic syndrome in obese and non-obese PCOS women. Middle East Fertility Society Journal. 2024 Jan 26;29(1):9.
  8. Al-Azzawi O. Prevalence of prediabetes and metabolic syndrome and their association in an Iraqi sample. IOSR J Dent Med Sci. 2015;14(9):10-6.
  9. Hosseinpour‐Niazi S, Afaghi S, Hadaegh P, et al. The association between metabolic syndrome and insulin resistance with risk of cardiovascular events in different states of cardiovascular health status. J of Diabetes Invest. 2024 Feb;15(2):208-18.
  10. Kuo TC, Lu YB, Yang CL, et al. Association of insulin resistance indicators with hepatic steatosis and fibrosis in patients with metabolic syndrome. BMC gastroenterology. 2024 Jan 9;24(1):26.
  11. Mukhopadhyay S, Mondal S. Metabolic Syndrome: From Mechanisms to Interventions. Elsevier Science & Technology; 2023.
  12. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005 Oct 25;112(17):2735-52.
  13. Vila G, Jørgensen JOL, Luger A, et al. Insulin Resistance in Patients With Acromegaly.Front Endocrinol (Lausanne). 2019;10:509.
  14. Park SB, Blumenthal JA, Lee SY, et al. Association of cortisol and the metabolic syndrome in Korean men and women. J Korean Med Sci. 2011 Jul;26(7):914-8.
  15. Ruhla S, Weickert MO, Arafat AM, et al. A high normal TSH is associated with the metabolic syndrome. Clin Endocrinol (Oxf). 2010 May;72(5):696-701.
  16. Grundy SM. Metabolic syndrome update. Trends Cardiovasc Med. 2016 May;26(4):364- 73.
  17. Groop L. Genetics of the metabolic syndrome. Br J Nutr. 2000 Mar;83 Suppl 1:S39-48.
  18. Hainer V, Aldhoon Hainerová I, Kunešová M, et al. Melanocortin pathways: suppressed and stimulated melanocortin-4 receptor (MC4R). Physiol Res. 2020 Sep 30;69(Suppl 2):S245-S254.
  19. Saklayen MG. The Global Epidemic of the Metabolic Syndrome. Curr Hypertens Rep.2018 Feb 26;20(2):12.
  20. Cornier MA, Dabelea D, Hernandez TL, et al. The metabolic syndrome. Endocr Rev.2008 Dec;29(7):777-822.
  21. Piercy KL, Troiano RP, Ballard RM, et al. The Physical Activity Guidelines for Americans. JAMA. 2018 Nov 20;320(19):2020-8.
  22. Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020 Dec;54(24):1451-62.
  23. Yang YJ. An Overview of Current Physical Activity Recommendations in Primary Care.Korean J Fam Med. 2019 May;40(3):135-42.
  24. Tune JD, Goodwill AG, Sassoon DJ, et al. Cardiovascular consequences of metabolic syndrome. Transl Res. 2017 May;183:57-70.
  25. Klop B, Elte JW, Cabezas MC. Dyslipidemia in obesity: mechanisms and potential targets.Nutrients. 2013 Apr 12;5(4):1218-40.
  26. Berberich AJ, Hegele RA. A Modern Approach to Dyslipidemia. Endocr Rev. 2022 Jul 13;43(4):611-53.
  27. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. 2006 May;23(5):469-80.
  28. Llewelyn H, Ang HA, Lewis KE, et al. Oxford handbook of clinical diagnosis. Oxford University Press, USA; 2014.
  29. Li YH, Chen JW, Lin TH, et al. A performance guide for major risk factors control in patients with atherosclerotic cardiovascular disease in Taiwan. J Formos Med Assoc. 2020 Mar;119(3):674-84.Xu JJ, Song Y, Jiang P, et al. Effects of metabolic syndrome on onset age and long-term outcomes in patients with acute coronary syndrome. World J Emerg Med. 2021;12(1):36- 41.
  30. Ismael S, Ahmed H, Hasan M. Prevalence of metabolic syndrome in a sample of population in Erbil city, Iraq. ZJMS. 2016 Sep 1;20(2):1280-7.
  31. Zamil AH, Amin SS. The prevalence of metabolic syndrome among university students in Wasit, Iraq. Saudi Med J. 2022 Nov;43(11):1240-7.
  32. Koutsovasilis A, Protopsaltis J, Triposkiadis F, et al. Comparative performance of three metabolic syndrome definitions in the prediction of acute coronary syndrome. Intern Med. 2009;48(4):179-87.
  33. Fanta K, Daba FB, Asefa ET, et al. Prevalence and Impact of Metabolic Syndrome on Short-Term Prognosis in Patients with Acute Coronary Syndrome: Prospective Cohort Study. Diabetes Metab Syndr Obes. 2021;14:3253-62.
  34. Al-Aqeedi RF, Abdullatef WK, Dabdoob W, et al. The prevalence of metabolic syndrome components, individually and in combination, in male patients admitted with acute coronary syndrome, without previous diagnosis of diabetes mellitus. Libyan J Med. 2013 Mar 19;8(1):20185.
  35. Prashant Udgire, Rajesh Dase, N D Karnik. The prevalence of metabolic syndrome in patients with acute coronary syndromes using ATP III definition. International Journal of current Medical and Applied sciences. 2017;13(2):116-121.
  36. Shehab A, Al-Dabbagh B, Almahmeed W, et al. Prevalence, Characteristics, and In- Hospital Outcomes of Metabolic Syndrome among Patients with Acute Coronary Syndrome in the United Arab Emirates. Open Cardiovasc Med J. 2012;6:81-7.
  37. Motar BA. Relation between Metabolic syndrome and acute coronary syndrome and arrhythmia in AL-Nasiriya city/Iraq. University of Thi-Qar Journal. 2017;12(2):79-93.
  38. Mohammad J, Sarbast S, Ahmed M. The Prevalence of Metabolic Syndrome in Coronary Artery Disease And The Association of Metabolic Syndrome with Severity of Coronary Artery Disease. juod. 2022 May 25;25(1):81-7.
  39. Rasul DA, Al-Othman AA. Impact of Metabolic Syndrome On Hospital Outcome In Patients With Acute Coronary Syndrome In Hawler Teaching Hospital. AMJ (Advanced Medical Journal). 2015;1(1):43-51.
  40. Upadhaya A, Godi V, Kaneria A, et al. Prevalence Of Metabolic Syndrome In Acute Coronary Syndrome. Journal of Survey in Fisheries Sciences. 2023 Jul 19:3192-200.
  41. Al-Rasadi K, Sulaiman K, Panduranga P, et al. Prevalence, characteristics, and in-hospital outcomes of metabolic syndrome among acute coronary syndrome patients from Oman.Angiology. 2011 Jul;62(5):381-9.
  42. Zhou J, Liu C, Zhou P, et al. Prevalence and impact of metabolic syndrome in patients with multivessel coronary artery disease and acute coronary syndrome. Nutrition, Metabolism and Cardiovascular Diseases. 2021 Aug 26;31(9):2693-9.
  43. Aldaggistany ZS, Ahmed IS, Al-Johar Z. Prevalence and Demographic characteristics of Metabolic Syndrome in Iraqi Patients with Acute Coronary Syndrome. Journal of the Faculty of Medicine Baghdad. 2023 Apr 27;65(1):8-14.
  44. Sinha SK, Goel A, Madaan A, et al. Prevalence of metabolic syndrome and its clinical and angiographic profile in patients with naive acute coronary syndrome in North Indian population. Journal of Clinical Medicine Research. 2016 Sep;8(9):667.
  45. Boulon C, Lafitte M, Richeboeuf V, et al. Prevalence of metabolic syndrome after acute coronary syndrome and its prognostic significance. The American journal of cardiology. 2006 Dec 1;98(11):1429-34.
  46. Wambua PM, Khan Z, Kariuki CM, et al. A Retrospective Study on the Adoption of Lipid Management Guidelines in Post-Myocardial Infarction Patients in a Tertiary Care Centre. Cureus. 2023 Jul 5;15(7).
  47. Chamsi-Pasha H, Taylor RJ, McDowell D, et al. Plasma lipids: when to measure after myocardial infarction?. The British Journal of Clinical Practice. 1989 Dec 1;43(12):447-50.
  48. Abdolmanafi A, Duong L, Ibrahim R, et al. Intravascular imaging of coronary artery: Bridging the gap between clinical needs and technical advances. Medical Engineering & Physics. 2021 Oct 1;96:71-80.
  49. Alegría E, Cordero A, Laclaustra M, et al. Prevalence of metabolic syndrome in the Spanish working population: MESYAS registry. Revista Española de Cardiología (English Edition). 2005 Jul 1;58(7):797-806.
  50. Latre ML, Andrés EM, Cordero A, et al. Relationship between metabolic syndrome and ischemic heart disease mortality in Spain. Revista Española de Cardiología (English Edition). 2009 Dec 1;62(12):1469-72.

Authors

Almomenbellah Ahmed Jasim

Kirkuk Health Department

Fakhir Yousif Hussein

Department of Medicine, College of Medicine, University of Mosul, Mosul, Iraq

Identifiers

https://doi.org/10.33899/acmm.v47i2.60225
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How to Cite

1.
Jasim AA, Hussein FY. Metabolic Syndrome Among Patients with Coronary Syndrome. Ann. coll. Med. Mosul [Internet]. 2025 Dec. 29 [cited 2026 Jan. 2];47(2):221-9. Available from: https://mmed.uomosul.edu.iq/index.php/mmed/article/view/60225