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Metabolic syndrome (MetS), a cluster of metabolic dysregulations, is recognized as a significant risk factor for the development of heart failure (HF). The pathophysiological mechanisms linking MetS to HF are complex and multifaceted, with the components of MetS contributing to cardiac deterioration through impaired myocardial energy metabolism, increased inflammation, and endothelial dysfunction. Numerous clinical studies have confirmed the relationship between MetS and HF. Multiple studies have demonstrated that the impact of MetS on HF varies by sex and age. Metabolic disorders, including MetS, have a greater impact on HF incidence in younger adults compared to the elderly population and in women compared to men. Although the reasons for these differences are not yet fully understood, recognizing the sex- and age-related variations is crucial for developing targeted strategies to prevent HF in individuals with MetS. Future research should continue to investigate the underlying mechanisms behind these variations and identify optimal management approaches that account for both sex and age in reducing HF risk. [ABSTRACT FROM AUTHOR]

Limited data are available regarding the effect of metabolic syndrome on heart failure (HF) development in young individuals. Utilizing data from the Korean National Health Insurance Service, we included a total of 1,958,284 subjects in their 40s who underwent health screening between January 2009 and December 2009 in Korea. Subjects were classified into three groups: normal, pre-metabolic syndrome (Pre-MetS), and metabolic syndrome (MetS). MetS was identified in 10.58% of males and 5.21% of females. The hazard ratio for HF in subjects with MetS was 1.968 (95% CI: 1.526–2.539) for males and 2.398 (95% CI: 1.466–3.923) for females. For those with Pre-MetS, the hazard ratio was 1.607 (95% CI: 1.293–1.997) in males and 1.893 (95% CI: 1.43–2.505) in females. Additionally, acute myocardial infarction and low hemoglobin levels were identified as significant risk factors for HF in both genders. MetS approximately doubled the risk of developing HF in individuals in their 40s. Pre-MetS was also a significant risk factor for HF in this population. [ABSTRACT FROM AUTHOR]

Background: Early risk stratification is necessary for optimal determination of the treatment strategy in cardiogenic shock (CS) complicating acute coronary syndrome (ACS). Therefore, we evaluated the prognostic impact of an intra-aortic balloon pump on the cardiogenic shock (IABP-SHOCK) II score according to the treatment strategies in ACS complicated by CS using the RESCUE (REtrospective and prospective observational Study to investigate Clinical oUtcomes and Efficacy of left ventricular assist device for Korean patients with cardiogenic shock) registry. Methods: The RESCUE registry contains multicenter observational retrospective and prospective cohorts that include 1247 patients with CS from 12 centers in Korea. A total of 865 patients with ACS complicated by CS were selected and stratified into low-, intermediate- and high-risk categories according to their IABP-SHOCK II scores and then according to treatment: non-mechanical support, IABP, and extracorporeal membrane oxygenators (ECMOs). The primary outcome was all-cause mortality during follow-up. Results: The observed mortality rates for the low-, intermediate-, and high-IABP-SHOCK II score risk categories were 28.8%, 52.4%, and 69.8%, respectively (p < 0.01). Patients in the non-mechanical support and IABP groups showed an increasingly elevated risk of all-cause mortality as their risk scores increased from low to high. In the ECMO group, the risk of all-cause mortality did not differ between the intermediate- and high-risk categories (HR = 1.21, 95% CI: 0.81–1.81, p = 0.33). The IABP-SHOCK II scores for the non-mechanical support and IABP groups showed a better predictive performance (area under curve [AUC] = 0.70, 95% CI: 0.65–0.76) for mortality compared with the EMCO group (AUC = 0.61, 95% CI 0.54–0.67; p-value for comparison = 0.02). Conclusions: Risk stratification using the IABP-SHOCK II score is useful for predicting mortality in ACS complicated by CS when patients are treated with non-mechanical support or IABP. However, its prognostic value may be unsatisfactory in severe cases where patients require ECMOs. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the impact of metabolic syndrome (MetS) status on the incidence of atrial fibrillation (AF) in Koreans. Methods and results: Data obtained from the Korean National Health Insurance Service from 2009 to 2016 were analyzed. In total, 7,830,602 men and women (between 30 and 69 years of age) without baseline AF who underwent a national health examination between January 2009 and December 2009 were enrolled. Patients were evaluated to determine the impact of MetS status on their risk of developing AF until December 2016. Using the National Cholesterol Education Program Adult Treatment Panel III criteria, patients were placed into one of three groups depending on MetS component numbers: 0 (normal), 1–2 (Pre-MetS) or 3–5 (MetS). During a mean follow-up of 7.3 years, 20,708 subjects (0.26%) were diagnosed with AF. After multivariable adjustment, the risk of AF was significantly and positively correlated with MetS status (hazard ratios (HR) 1.391, 95% confidence interval (CI) 1.322–1.464 in Pre-MetS and HR 1.722, 95% CI 1.621–1.829 in MetS). When subgroup analyses were conducted according to MetS components, abdominal obesity (HR 1.316, p < 0.001), elevated blood pressure (HR 1.451, p < 0.001), and elevated fasting glucose (HR 1.163, p < 0.001) were associated with an increased risk of AF. Conclusion: MetS and pre-MetS are significantly associated with an increased risk of AF in Korean adults. Of the MetS components, abdominal obesity, elevated blood pressure, and elevated fasting glucose are potent risk factors for the risk of AF in this population. [ABSTRACT FROM AUTHOR]