High prevalence of metabolic syndrome among young women with nonfatal myocardial infarction

Objective: The aim of this study was to determine if the metabolic syndrome (MetS) or other risk factors might be common among young women with nonfatal myocardial infarction (MI). Methods: A matched case-control study using a structured interview and questionnaires, plus analysis of conventional and nonconventional risk factors for MI in serum or plasma was carried out at a teaching hospital. Subjects were 40 women with nonfatal MI at or before age 45 and an equal number of age-matched, ethnicity-matched, and smoking-matched female control subjects. Results: Cases and control subjects were not significantly different with regard to serum or plasma levels of homocysteine, anticardiolipin antibodies, beta(2)-glycoprotein 1, prothrombin, folate, vitamin B-12, high-sensitivity C-reactive protein (CPR), fibrinogen, amyloid A, plasminogen activator inhibitor type 1 (PAI-1), or tissue plasminogen activator (tPA) antigen levels. Compared with matched controls, cases had a higher rate of obesity (37% vs. 12%, p 0.02), a higher proportion of fasting glucose greater than or equal to110 mg/dl (9% vs. 1%, p = 0.01), and higher overall insulin resistance (27% vs. 5%, p = 0.007). Type 2 diabetes tended to be more common in cases (17% vs. 5%, P = 0.10). Cases were also more likely to, be hypertensive (35% vs. 12%, p = 0.04) and dyslipidemic (80% vs. 42%, p = <0.001) and to have higher triglyceride levels (110 +/- 13 mg/dl vs. 96 +/- 12, P = 0.02). Overall, after controlling for weight, cases were 4.7 times more likely to have three or more diagnostic criteria of the MetS than matched controls: chi-square = 7.2, OR = 4.7, 95% Cl (1.3, 25.3), p = 0.008. Conclusions: Although this study may have been underpowered to recognize the contribution of other risk factors, we found that the dominant predictor of nonfatal MI in young women-was the MetS. Screening young women with central obesity for other parameters of the MetS may help reduce the risk of MI at an early age.