Adverse events after coronary artery bypass grafting in patients with preoperative metabolic syndrome: A 10-year follow-up of the Veterans Affairs Database

Deo, Salil V.; Sundaram, Varun; Wilson, Brigid; Sahadevan, Jay; Mohan, Sri Krishna Madan; Rubelowsky, Joseph; Elgudin, Yakov; Cmolik, Brian

doi:10.1016/j.jtcvs.2020.08.018

Cited by 9 publications

(9 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A survey indicated that 33.9% (31% in males and 36.8% in females) had MS in mainland China in 2010 (12). In patients with established CVD, the prevalence of MS ranged from 29 to 66% in previous reports (13)(14)(15)(16)(17). A single-center, prospective, and observational study was conducted by Sinha et al showed that patients with NSTEACS were more common than STEMI in MS group (18).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Metabolic Syndrome in Patients With Non-ST Elevated Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Zhao

Liu

Xiao

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

ObjectiveWe aim to investigate the prognostic effects of metabolic syndrome (MS) on patients with non-ST elevated myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI).MethodsPatients with NSTEMI undergoing PCI were consecutively collected. According to the presence or absence of MS, they were divided into two groups and followed up for 1 year. The endpoint was major adverse cardiovascular events (MACE), including all-cause death, unstable angina hospitalization, heart failure (HF) hospitalization, non-fatal recurrent myocardial infarction (MI), and target lesion revascularization. Also, six subgroups were made according to gender, age, left ventricular ejection fraction (LVEF), Global Registry of Acute Coronary Events (GRACE) score, hypersensitive troponin (hsTNT), and several diseased vessels. Cox proportional hazard model was adopted to analyze the effect of MS on MACE in all the patients and different subgroups.ResultsA total of 1,295 patients were included in the current analysis and 660 (50.97%) of them had MS. About 88 patients were lost to follow-up, and the overall average follow-up was 315 days. MS was an independent risk factor for MACE (HR 1.714, CI 1.265–2.322, p = 0.001), all-cause death, heart failure (HF) hospitalization, and non-fatal recurrent MI. In the MS component, BMI ≥28 kg/m2 was positively associated with MACE. Subgroup analysis indicated the prognostic value of MS was more striking for patients with the following: age of >60, LVEF of ≤40%, GRACE of >140, multivessel disease, or hsTNT of >0.1 ng/ml.ConclusionsThe MS was a robust adverse prognostic factor in patients diagnosed with NSTEMI, especially among those of older age and at higher ischemic risk. A BMI of ≥28 kg/m2 independently predicted the occurrence of MACE. Prognosis may be improved by controlling abdominal obesity.

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Metabolic Syndrome in Patients With Non-ST Elevated Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Zhao

Liu

Xiao

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…In addition, a systematic review of 55 studies with 162, 450 participants with cardiovascular disease observed a relationship between MS and increased relative risk (RR) for mortality from all causes (RR, 1.220; 95% CI, 1.103–1.349), death from cardiovascular disease (RR, 1.360; 95% CI, 1.152–1.606), MI (RR, 1.460, 95% CI 1.242–1.716), and stroke (RR, 1.435, 95% CI 1.131–1.820) compared with patients without MS [ 35 ]. Many studies have shown that poor outcomes are linked to MS in patients undergoing coronary revascularization [ 31 , 32 , 33 , 36 , 37 , 38 ]. The ten-year rates of cardiovascular events were observed to be elevated in MS patients after coronary artery bypass grafting [ 38 ], while Lovic et al reported an independent association between MS and reduced overall survival in patients with acute MI after coronary stenting [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have shown that poor outcomes are linked to MS in patients undergoing coronary revascularization [ 31 , 32 , 33 , 36 , 37 , 38 ]. The ten-year rates of cardiovascular events were observed to be elevated in MS patients after coronary artery bypass grafting [ 38 ], while Lovic et al reported an independent association between MS and reduced overall survival in patients with acute MI after coronary stenting [ 31 ]. Hu et al and Wang et al also found an increased incidence of MACE in Chinese patients with MS after PCI [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Metabolic Syndrome and Clinical Outcome in Patients Treated with Drug-Eluting Stenting after Rotational Atherectomy for Complex Calcified Coronary Lesions

Xiao

Wang

et al. 2022

JCM

View full text Add to dashboard Cite

Background and aims: although an association between metabolic syndrome (MS) and cardiovascular disease risk has been documented, the relationship in patients with complex calcified coronary lesions undergoing rotational atherectomy (RA) and drug-eluting stent(DES) insertion remains controversial. Here, the influence of MS on outcomes was assessed. Methods and results: we retrospectively included 398 patients who underwent RA and DES insertion for complex calcified coronary lesions in our institution between June 2015 and January 2019. The modified Adult Treatment Plan III was used to diagnose MS. The endpoint was major adverse cardiovascular events (MACEs), comprising mortality from all causes, myocardial infarction, and target vessel revascularization (TVR). In all, 173 (43.5%) patients had MS. MS was significantly associated with MACE over the 28.32 ± 6.79-month follow-up period (HR 1.783, 95% CI from 1.122 to 2.833) even after adjustment for other possible confounders. Conclusion: MS was frequently observed in patients treated with RA with DES insertion for complex calcified coronary lesions. MS independently predicted MACE in these patients.

show abstract

“…Obesity, diabetes, hypertension, and dyslipidemia are not binary, and the composite of them certainly is not. This may be the most likely explanation why Deo and colleagues 2 were not able to show a difference in operative or longer-term mortality. Furthermore, veterans have a higher prevalence of substance abuse, hepatitis, and mental health issues, all of which affect both the exposure and the outcomes reported in this study.…”

mentioning

confidence: 91%

Commentary: The original pandemic—stemming the tide of overweight, diabetes, hypertension, and dyslipidemia after coronary artery bypass grafting

Ballmoos

Almassi

2022

The Journal of Thoracic and Cardiovascular Surgery

View full text Add to dashboard Cite

Adverse events after coronary artery bypass grafting in patients with preoperative metabolic syndrome: A 10-year follow-up of the Veterans Affairs Database

Cited by 9 publications

References 18 publications

Prognostic Value of Metabolic Syndrome in Patients With Non-ST Elevated Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Prognostic Value of Metabolic Syndrome in Patients With Non-ST Elevated Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Relationship between Metabolic Syndrome and Clinical Outcome in Patients Treated with Drug-Eluting Stenting after Rotational Atherectomy for Complex Calcified Coronary Lesions

Commentary: The original pandemic—stemming the tide of overweight, diabetes, hypertension, and dyslipidemia after coronary artery bypass grafting

Contact Info

Product

Resources

About