Impact of Metabolic Syndrome on 10-Year Clinical Outcomes Among Patients With Acute Coronary Syndrome

Abstract

Background: Metabolic syndrome (MetS) is a risk factor and prognosticator for ischemic heart disease, but its actual effect on long-term mortality after acute coronary syndrome (ACS) remains unknown. Methods and Results: All-cause death and cardiovascular death were investigated among patients with ACS upon admission who underwent complete revascularization by either percutaneous coronary intervention or bypass surgery between 1984 and 1992. MetS was defined according to the NCEP/ATPIII criteria modified for waist circumference. From among 1,836 patients who underwent complete revascularization during the study period, 384 (21.0%) with ACS were enrolled, of whom 163 (42.5%) had MetS. During a mean follow-up of 10.4±3.4 years, the total number of deaths was 83 (21.6%), of which 38 (9.9%) were from cardiovascular causes. Cox proportional hazard analysis revealed that MetS increased the risk of mortality by a ratio of 1.62 (95% confidence interval (CI) 1.01-2.59, P=0.046) and of cardiovascular death by 2.40 (95%CI 1.16-4.94, P=0.018) in patients with ACS. Conclusions: MetS is a powerful determinant of long-term all-cause and cardiovascular death after ACS. Furthermore, MetS and ACS might jointly exacerbate poor long-term outcomes. (Circ J 2009; 73: 1454 -1458

Metabolic Syndrome as a Risk Factor for Postoperative Kidney Injury After Off-Pump Coronary Artery Bypass Surgery

“…10, 27 However, in our study, MetS was not associated with mortality. The reason is not clear, but it might be that OPCAB has better outcomes regarding morbidity and mortality in high-risk patients, 28 and our institution has a high level of experience with OPCAB.…”

The Impact of Metabolic Syndrome on Clinical Outcomes After Everolimus-Eluting Stent Implantation

“…1,2 MetS has also been reported to increase the risks of restenosis and subsequent cardiovascular events in patients who underwent percutaneous coronary intervention (PCI) with balloon angioplasty and bare metal stents. 3,4 However, it remains unclear whether MetS is associated with adverse cardiovascular outcomes after PCI in the era of drug-eluting stents (DESs) because cardiovascular outcomes have continuously been improving using dual antiplatelet agents, statins, intracoronary imaging techniques, and DESs. Recently, paradoxical association between obesity and favorable clinical outcomes have been increasingly recognized in cardiovascular research.…”

The metabolic syndrome entanglement: cutting the Gordian knot

“…In addition, a very important finding of this study demonstrated that CV risk was still high in patients with MS but without diabetes. Moreover, it was demonstrated that the syndrome predicts CV events or/and diabetes independently from other conventional risk factors [29,30]. Our group has shown that MS is a strong independent predictor of mortality and morbidity in patients with acute coronary syndrome [30].…”