Prevalence of Metabolic Syndrome and its Clinical and Angiographic Profile in Patients with Naive Acute Coronary Syndrome

Abstract

Sir, Kumar et al.[1] found in their study that the metabolic syndrome (MetS) prevalence was high (46.2%) among Indian patients with naive acute coronary syndrome (ACS) and patients with MetS tended to have more complex coronary lesions. Based on the following limitation, we believe that the study findings are questionable. The revised National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) guidelines[2] employed in the study to diagnose MetS include the following parameters: (1) abdominal obesity manifests as waist circumference (WC) ≥102 cm for men or ≥88 cm for women; (2) serum triglyceride (TG) level ≥150 mg/dL; (3) serum high-density lipoprotein cholesterol (HDLC) level ≤40 mg/dL for men or ≤50 mg/dL for women; (4) systolic/diastolic blood pressure (BP) ≥130/85 mmHg or receiving drug therapy; and (5) fasting plasma glucose (FBG) ≥100 mg/d. These guidelines were launched in 2005[2] and they are no more righteous. Around the world, many committees have built their MetS definition guidelines centered on various factors such as age, gender, pubertal stage, socioeconomic class, and ethnicity to accurately measure MetS prevalence.[3,4] Importantly, India released national diagnostic guidelines for MetS in 2016. These guidelines involve the following components: (1) WC ≥31” In women and ≥35” in men; (2) serum TG level ≥150 mg/dl; (3) serum HDLC level <50 mg/dl for women and <40 mg/dl for men; (4) BP ≥130/85 mmHg; and (5) FBG >100 mg/dl.[5] Since there are noticeable variations between the revised NCEP/ATP III guidelines[2] and national MetS diagnostic guidelines,[5] we believe that referring to the national guidelines could make an accurate estimate of the MetS prevalence among ACS Indian patients and assess the seriousness of coronary artery disease in those with and without MetS. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.