The Metabolic Syndrome and Mortality in an Ethnically Diverse Heart Failure Population

• Published in: Journal of cardiac failure 2008-09, Vol.14 (7), p.590-595
• Main Authors: Hassan, Saamir A., MD, Deswal, Anita, MD, MPH, Bozkurt, Biykem, MD, Aguilar, David, MD, Mann, Douglas L., MD, Pritchett, Allison M., MD
• Format: Article
• Language: English
• Subjects: Adult; African Americans - statistics & numerical data; Age Factors; Aged; Cardiovascular; Cohort Studies; Coronary Artery Disease - epidemiology; Cultural Diversity; Electrocardiography; Ethnic Groups; European Continental Ancestry Group - statistics & numerical data; Female; Follow-Up Studies; Heart failure; Heart Failure - epidemiology; Heart Failure - ethnology; Heart Failure - mortality; Hispanic Americans - statistics & numerical data; Hospitalization - statistics & numerical data; Humans; Male; metabolic syndrome; Metabolic Syndrome - epidemiology; Metabolic Syndrome - ethnology; Middle Aged; mortality; Patient Discharge - statistics & numerical data; Prevalence; Retrospective Studies; Risk Factors; Sex Factors; Stroke Volume - physiology; Texas - epidemiology
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2008.03.004

Abstract Background In the general population, 27% of adults have the metabolic syndrome (MetS) and is associated with increased mortality. Similar data are not available for a heart failure (HF) population. This study sought to determine the prevalence of the MetS and its effect on mortality in a HF population. Methods and Results Patients (n = 886) discharged from the hospital with a primary diagnosis of HF were retrospectively identified. Demographic, clinical, and laboratory data were extracted by chart review. The MetS was defined according to National Cholesterol Education Program Expert Panel criteria with a body mass index ≥30 kg/m2 substituted for increased waist circumference. Mortality data were acquired by query of the National Death Index, with a median follow-up of 856 days. Data were available to evaluate for the presence or absence of MetS in 71% (n = 625). The prevalence of MetS in this cohort was 68%. MetS was most common in Hispanics (79%) compared with whites (70%) and blacks (61%, P = .003). Mortality was lower in those with MetS (44%) compared with those without (58%, unadjusted HR 0.67 [95% CI, 0.53–0.85]). In a fully adjusted model, there was still a significantly lower risk of mortality in those with MetS (adjusted HR 0.73 [95% CI, 0.56–0.94]). Conclusions In a cohort hospitalized with HF, the prevalence of MetS exceeds that of the general population, and unlike the general population, MetS is associated with a lower mortality.