Metabolic Syndrome Increases Operative Mortality in Patients Undergoing Coronary Artery Bypass Grafting Surgery

Echahidi, Najmeddine; Pîbarot, Philippe; Després, Jean‐Pierre; Daigle, Jean-Marc; Mohty, Dania; Voisine, Pierre; Baillot, Richard; Mathieu, Patrick

doi:10.1016/j.jacc.2007.04.075

Cited by 94 publications

(83 citation statements)

References 33 publications

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“…However, DM is a critical predictor of future cardiovascular events. The risk of death among patients with MetS was mainly associated with transformation in DM; these patients developed a significantly increased risk of DM during follow-up 4,23,24 and approximately 33% of patients who develop new MI also develop abnormal glucose tolerance or diabetes within 3.5 years. 25 This is the first study to provide such evidence in an Oriental population over the long-term (>10 years of followup), and it is compatible with the results of Western randomized control studies of shorter follow-up periods.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Moreover, MetS is associated with the severity of coronary artery disease (CAD), 3 and is a prevalent and powerful risk factor for operative mortality in patients undergoing coronary artery bypass surgery (CABG). 4 Acute coronary syndrome (ACS) is associated with higher rates of morbidity and mortality, and the risk of recurrent ischemic events is greater than after stable angina. 5,6 Considerable evidence shows that MetS is highly prevalent among patients with ACS.…”

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confidence: 99%

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

Dohi

Miyauchi

Kasai

et al. 2009

Circ J

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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

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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

Dohi

Miyauchi

Kasai

et al. 2009

Circ J

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“…In a study of 5304 consecutive CABG patients, those with metabolic syndrome had a 2.7-times higher in-hospital mortality than those without metabolic syndrome, a risk that was independent of the presence of diabetes mellitus. 399 Moreover, patients with metabolic syndrome also have an increased risk for long-term mortality. Angeloni et al 398 noted that all-cause mortality was 50% higher in those patients with metabolic syndrome compared with those without in a long-term follow-up study of 1726 CABG patients.…”

Section: Obesity and Metabolic Syndromementioning

confidence: 99%

Secondary Prevention After Coronary Artery Bypass Graft Surgery

Kulik¹,

Ruel²,

Jneid³

et al. 2015

Circulation

335

185

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“…The anesthetic and surgical techniques were standardized for all patients and described previously. 18 …”

Section: Study Populationmentioning

confidence: 99%

Statins Reduce Short‐ and Long‐Term Mortality Associated With Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: Impact of Postoperative Atrial Fibrillation and Statin Therapy on Survival

Girerd¹,

Daleau²,

Voisine

et al. 2012

Clinical Cardiology

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Background:Postoperative atrial fibrillation (POAF) is a frequent complication of coronary artery bypass grafting (CABG) surgery. The objective of this study was to determine the impact of POAF on both short‐ and long‐term mortality following isolated CABG.Hypothesis:POAF is associated with a poorer short and long‐term mortality following CABG.Methods:We retrospectively analyzed the preoperative and operative data of 6728 consecutive patients undergoing a first isolated CABG.Results:The incidence of POAF was 27.8%. Operative mortality was higher in patients with POAF compared to those without POAF (2.3% vs 0.9%, P < 0.001). On multivariate analysis, POAF remained an independent predictor of operative mortality (odds ratio [OR]: 1.78, P = 0.01). Patients with POAF also had reduced long‐term survival (6‐year survival: 85.3% vs 89.2%, P < 0.001). After adjusting for other predictors of mortality, POAF was significantly associated with increased long‐term mortality (hazard ratio [HR]: 1.35, P = 0.04). Of note, after adjustment for potential confounders, statin treatment had a highly protective effect in POAF patients for both operative mortality (OR: 0.38, P = 0.003) and long‐term mortality (HR: 0.62, P = 0.03), whereas it had no significant effect in patients without POAF.Conclusions:POAF is an independent predictor of both short‐ and long‐term mortality following CABG. Moreover, statin therapy was independently associated with better survival in patients with POAF.Dr. Pibarot holds the Canada Research Chair in Valvular Heart Diseases, Canadian Institutes of Health Research. Dr. Mathieu is a research scholar from the Fonds de Recherches en Santé du Québec, Montreal, Canada. Dr. Després has served as a speaker for Abbott Laboratories, AstraZeneca, Solvay Pharma, GlaxoSmithKline, and Pfizer Canada Inc.; has received research funding from Eli Lilly Canada; and has served on the advisory boards of Novartis, Theratechnologies, Torrent Pharmaceuticals Ltd., and Sanofi‐Aventis. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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Metabolic Syndrome Increases Operative Mortality in Patients Undergoing Coronary Artery Bypass Grafting Surgery

Cited by 94 publications

References 33 publications

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

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

Secondary Prevention After Coronary Artery Bypass Graft Surgery

Statins Reduce Short‐ and Long‐Term Mortality Associated With Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: Impact of Postoperative Atrial Fibrillation and Statin Therapy on Survival

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