Heart World Conference 2026

Abstract

Background
Metabolic Syndrome (MetS) is a highly prevalent condition among patients with acute
myocardial infarction (AMI) in the intensive care unit (ICU), yet its direct impact on inhospital
outcomes remains a subject of debate. This systematic review aims to
synthesize the current evidence on the prevalence of MetS in critically ill AMI patients
and its association with clinical severity and in-hospital mortality.
Methods
This is a systematic observational study. Data on patients’ demographics, clinical
characteristics, and clinical outcomes were systematically extracted and synthesized.
The study focused on prevalence rates, patient characteristics including age, gender,
body mass index, waist circumference, and comorbidities, as well as in-hospital
outcomes such as mortality, heart failure, and major adverse cardiovascular events.
Results
The prevalence of MetS in patients with AMI in the ICU setting is consistently high,
ranging from 46% to 68.3% across different populations [1, 2]. Patients with MetS are
more likely to be female and present with a higher body mass index (BMI), larger waist
circumference, and a greater incidence of hypertension and diabetes. While some
studies report no significant increase in all-cause in-hospital mortality, others indicate
a significantly higher rate of cardiovascular mortality (P = .03) and an increased risk of
complications such as congestive heart failure and recurrent myocardial ischemia [1,
3]. Specific components of MetS, notably hyperglycemia and a BMI ≥28 kg/m², have
been identified as independent predictors of major adverse cardiovascular events
(MACE) [2]. The pathophysiological mechanisms underlying these outcomes
demonstrate the complex interplay between MetS components and myocardial
dysfunction.
Conclusion
Metabolic Syndrome is a major health burden in critically ill patients with AMI,
associated with a higher risk of specific in-hospital complications, even if its role in allcause
mortality is not definitively established. The underlying pathophysiology
involves a complex interplay of systemic inflammation, endothelial dysfunction, and a
prothrombotic state, which collectively drive myocardial fibrosis and ventricular
hypertrophy, culminating in myocardial dysfunction. These findings underscore the
critical need for early identification and aggressive management of MetS and its
components to improve outcomes in this high-risk population. Further large-scale
prospective studies are warranted to clarify the prognostic implications of MetS in the
ICU.
Keywords
Metabolic Syndrome, Myocardial Dysfunction, Critical Care, Intensive Care Unit (ICU),
Acute Myocardial Infarction (AMI), In-Hospital Outcomes, Cardiovascular Mortality.