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

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.