Association of Silent Myocardial Ischemia in Obese Patients with Metabolic Syndrome

Abstract Background: Egypt is among the first four countries suffering from obesity worldwide. The function of waist circumference [WC] as an independent indicator of silent myocardial ischemia [SMI] remains unknown in Egyptian obese patients. Thus, we aimed to detect SMI in a cohort of Egyptian obese individuals with metabolic syndrome [MS] and to examine its associations with various clinical and diagnostic results. Methods: Fifty obese patients (G1) without overt coronary artery disease [“60 percent” females and “40 percent” males; mean age 40.2±4.5 years] and 50 ages & sex matched non-obese subjects who served as control group (G2) were enrolled in this study. Anthropometric tests were taken for both subjects. Laboratory evaluation included fasting blood sugar, serum triglycerides, high density lipoprotein cholesterol. Assay of serum uric acid, urea, creatinine and microalbuminuria. MS was established through the revised National Education Program on Cholesterol [NCEP-R]. Tc99 m SestaMIBI SPECT gated myocardial perfusion imaging [GSPECT] was used for SMI screening. Pearson Moment correlation equation was used to check correlation between different variables. The logistic regression analysis was performed univariate and multivariate and the linkages between SMI and significant variables were established. Results: In (G1), 13/50 [26%] had SMI as compared to 2/50 [4%] among (G2) p=0.0001]. GSPECT positivity signif-icantly correlated with HDL (r=0.4; p= 0.02); microalbuminuria [r= =0.5; p=0.04]; and WC [r=0.6; p 0.04]. Neither WC (OR 1.042; CI 0.8701.248; p=0.654) nor microalbuminuria (OR 1.794, CI 0.6734.784; p=0.243) were considered as independent predictor of SMI. Conclusion: A significant association of SMI has been found among a cohort of Egyptian obese patients with MS using Tc99 m SestaMIBI GSPECT. Considering the fact, we believe that the latter has a place as a screening tool; whenever the diagnosis is made the better the result.