Metabolic Syndrome in Patients With First-ever Ischemic Stroke: Prevalence and Association With Coronary Heart Disease

Abstract Background: Most studies of metabolic syndrome (MetS) and coronary heart disease (CHD) have been carried out in the general population, and their association among stroke patients has been rarely explored. We seek to describe the prevalence of MetS among patients with acute ischemic stroke and to assess its association with CHD. Methods: This hospital-based study included 1851 patients with first-ever acute ischaemic stroke (mean age 61.2 years, 36.5% women) who were hospitalized into two university hospitals in Shandong, China (January 2016-February 2017). Data were collected through interviews, physical examinations, and laboratory tests. MetS was defined following the National Cholesterol Education Program (NCEP) criteria, the International Diabetes Federation (IDF) criteria, and the Chinese Diabetes Society (CDS) criteria. CHD was defined according to clinical and electrocardiogram examinations. Binary logistic regression was performed to determine the associations between MetS and CHD. Results: The overall prevalence of MetS was 34.0% by NECP criteria, 47.8% by IDF criteria, and 32.9% by CDS criteria. The prevalence of MetS decreased with age and was higher in women than men (p<0.05). Abdominal obesity, high blood pressure, high triglycerides, and low HDL-C were significantly associated with CHD (multi-adjusted OR range: 1.27-1.43, p<0.05). Compared with those without MetS, the multi-adjusted OR (95% CI) of CHD associated with MetS defined by the NECP criteria, IDF criteria, and CDS criteria was 1.29 (1.04-1.59), 1.46 (1.20-1.78), and 1.29 (1.05-1.59), respectively. In addition, having 1-2 abnormal components (vs. none) was associated with CHD (OR range: 1.63-1.73, p<0.05). Conclusions: MetS affects over one-third of patients with first-ever ischemic stroke. MetS is associated with an increased likelihood of CHD in stroke patients, but treating MetS as a binary entity would underestimate its association with CHD.