Metabolic syndrome predicts lower functional recovery in female but not in male patients after an acute cardiac event

Abstract 

Aims

To evaluate whether metabolic syndrome MS has a gender dependent effect on the recovery of functional capacity in patients (pts) with coronary heart disease (CHD) undergoing a cardiac rehabilitation program.

Methods and Results

We studied 286 CHD patients, age 66.2±10.6 (median±SD); M/F 187/99. Patients were divided into two groups according to the presence (MS, 48%) or not (nMS, 52%) of MS. MS was present in 48% of patients. Functional capacity was assessed by the distance walked at six minute walking test (6MWT), and by a maximal exercise test. Compared to patients without MS, those with MS walked a lower distance at 6MWT (438±110 vs 408±123 m; p<0.05), had a lower maximal exercise capacity (7.6±1.8 vs 9.3±1.2 MET; p<0.05) and a lower heart rate recovery (HRR) (16±9 vs 22±8; p<0.05). Male patients with or without MS had a similar degree of functional recovery (51%) while women with MS had a significantly lower recovery than nMS (20% vs 40%). In a multivariate logistic regression model, including body mass index, age, gender hypertension, ejection fraction and diabetes, MS predicted a reduced performance at 6MWT in the overall population (OR 1.4, 95% CI 1.7 to 2.4) and in women (OR 1.31; 95% CI 1.20–1.62), while it was not predictive in males.

Conclusions

CAD patients with MS have lower functional recovery and HRR than nMS. However MS is an independent predictor of lower exercise capacity only in female gender.

Keywords: Metabolic syndrome, Coronary artery disease, Gender, Exercise, Cardiac rehabilitation