The effects of the metabolic syndrome on coronary artery bypass grafting surgery

Abstract

SummaryBackgroundThe metabolic syndrome (MS) is a clustering of factors that are associated with increased cardiovascular risk. A low-grade inflammatory process acts as the underlying pathophysiology, which suggests that the MS may have a detrimental effect on coronary interventions, including coronary artery bypass grafting (CABG) surgery performed with cardiopulmonary bypass (CPB). We aimed to evaluate the effect of the MS on morbidity and mortality rates in the early postoperative period in patients undergoing CABG.MethodsWe prospectively included 152 patients (109 males and 43 females; mean age 60.1 ± 8.6 years) who underwent elective CABG on CPB between January and September 2011. Early postoperative morbidity and mortality rates were compared between subjects with and without the MS. Diagnosis of the MS was based on the American National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria.ResultsOf the study group, 64 patients (42%) had the MS. The two groups were similar in age and gender. In the postoperative period, rates of atrial fibrillation, wound infection, pulmonary complications, and lengths of intubation, hospitalisation and intensive care unit stay were significantly higher in MS patients (p < 0.01). The MS was significantly associated with wound infection (OR 6.64, 95% CI: 1.72–25.75), pulmonary complications (OR 6.44, 95% CI: 1.58–26.33), arrhythmia (OR 5.47, 95% CI: 1.50–19.97) and prolonged intubation (OR 1.17, 95% CI: 1.05–1.32). The mortality rate was 3.1% in the MS group and 1.1% in the non-MS group, with no significant difference (p > 0.05).ConclusionThe MS was associated with a higher rate of early postoperative morbidity following CABG, without having a significant effect on the mortality rate.

In-hospital mortality and complications following coronary artery bypass surgery; is it possible to predict with preoperative values?

“…In our study, the diagnosis of MS in was not found to be predictive of postoperative complications and mortality in our patient population. Similar to our conclusion, there are studies that have not found any association between mortality and MS (20,21) . Mean preoperative fasting blood glucose was found to be 134±141 mg dL -1 in patients with and without mortality and 133±144 mg dL -1 in patients with and without complication.…”

The effect of the number of vessel grafts used in coronary artery bypass grafting surgery to short-term mortality

“…It is known that the female gender is also a risk factor that increases mortality [9][10][11] . Of those, 17 of patients were female, and 19 were male (p>0,05).…”

“…Coronary artery bypass surgery can be performed safely by an experienced team using advanced technology in addition to the timing of the surgery 7,8 . Determining additional risk factors and predicting the possible complications of these factors increases the success of the surgery [9][10][11] .…”

Risk of postoperative pulmonary complications in adult surgical patients with metabolic syndrome: a systematic review and meta-analysis protocol

“…For patients undergoing hepatic surgery, having MetS increases the risk of unplanned re-intubation and prolonged ventilatory time twofold [23]. In a study reporting on outcomes for patients undergoing cardiac surgery, rates of PPC and length of ventilatory time were significantly higher in patients with a MetS profile [24]. In another retrospective cohort study of 310,280 patients undergoing non-cardiac surgery, the risk for PPC was approximately 1.5 to threefold higher in patients when accompanied by a MetS diagnosis [25].…”