Prevalence of the metabolic syndrome in patients with transient ischemic attack or non-cardioembolic stroke

Introduction. The presence of metabolic syndrome (MS) in patients with ischemic stroke has been analyzed in few studies and there is evidence that the coexistence of MS and stroke increases the subsequent risk of vascular recurrences, regardless of the classical risk factors (RF). One of the main objectives of the APICA study (prevalence of peripheral arterial disease and metabolic syndrome in acute cerebral ischemia) is to analyze this prevalence in Spain in patients with acute cerebral ischemia and to identify clinical variables with a higher risk of MS. Methods. An epidemiologic, observational, longitudinal, multicenter study including patients over 50 with non-cardioembolic transient ischemic attack (TLA) or ischemic stroke, consecutively recruited. The definition criteria of MS are those of the Adult Treatment Panel III-modified (ATP-IIIm) and of the International Diabetes Federation (LDF) 2005. The statistical analysis was made using the SPSS 15.0 program. A multivariate analysis was performed with the logistic regression models to determine factors associated independently with MS by both criteria. Results. In the study, 977 patients were analyzed: 651 (66.7%) were men and mean age was 69.1 years. Approximately two thirds had MS, 66.8% according to the modified ATP-III criteria and 65.1% by the IDF criteria. The factors related with MS by the modified ATP-III were independently associated with gender (OR 5.34 [2.99-9.54], p<0.001). The variables related with MS by IDF were independently associated with female gender (6.39 [3.55-11.5], p<0.001) and a greater concentration of platelets (1.005 [1.002-1.008], p=0.004). Conclusions. An elevated prevalence of MS is found in patients with transient ischemic attack or non-cardioembolic stroke, it being similar in both criteria used (66.8% and 65.1%). Female gender is a clearly significant risk factor and is related independently of the variable that determine MS.