Impact of metabolic syndrome and C-reactive protein on outcome after coronary stenting

Abstract

Metabolic syndrome (MS) identifies cardiovascular risk; however, there is little information regarding the evolution of patients with MS after stent implantation. The aim of this single-center study is to evaluate the possible association between MS and clinical restenosis, after adjustment for highsensitivity C-reactive protein (hs-CRP) and angiographic predictors of restenosis. In a longitudinal study, 159 patients (89 with and 70 without MS) were studied. Criteria for MS were: elevated blood pressure (systolic >or=130 mmHg, diastolic >or=85 mmHg or drug treatment for hypertension; elevated fasting glucose (>100 mg/dl) or drug treatment for elevated glucose; reduced HDL-cholesterol (<40 mg/dl in men and <50 mg/dl in women) or drug treatment for reduced HDL-cholesterol; elevated triglycerides (>or=150 mg/dl) or drug treatment for elevated triglycerides; and obesity (body mass index >28.8 kg/m2). The primary end point was the rate of major adverse clinical events (MACE): cardiovascular death, myocardial infarction, or target lesion revascularization (TLR) during the 12-month follow-up period. The secondary end point was the rate of TLR. MS was neither identified as predictor of MACE [hazard ratio (HR): 0.844; 95% CI: 0.41-1.74; p=0.648], nor TLR (HR: 1.05; 95% CI: 0.44-2.50; p=0.91), even when controlled for hs-CRP levels and angiographic predictors of restenosis. Also, no significant interaction between MS and hs-CRP was found (p=0.135 and p=0.194, for MACE and TLR, respectively). This study shows that patients with MS do not have an additional risk of MACE, even when controlled for angiographic predictors of restenosis and hs-CRP.

Risk of major adverse cardiovascular events in patients with metabolic syndrome after revascularization: A meta-analysis of eighteen cohorts with 18457 patients

“…Duplicate publications could introduce substantial bias, thus only one or two of them, without duplicate participants, were available in the individual meta-analysis. Among the included studies, the followups varied from one to twelve years, and four [9,11,22,24] were retrospective cohorts. Studies were published between 2005 and 2014, with sample sizes varying from 157 to 6352.…”

“…Studies were published between 2005 and 2014, with sample sizes varying from 157 to 6352. Ten trials [10][11][12][14][15][16][17]19,20,[23][24][25]28] were performed in eastern countries (China, Japan, and Korea) and the remaining [9,13,18,21,22,26,27,29] in western countries (Italy, USA, Germany, Greece, and Brazil). Of these trials, three of them with four publications [12,16,21,27] were conducted in patients without DM.…”

“…MetS was reported to be associated with increased risks of type 2 diabetes mellitus (DM), cardiovascular and cerebrovascular events, and chronic kidney disease (CKD) [5][6][7][8]. Several studies [9][10][11][12][13][14][15][16][17][18][19][20] have reported that MetS is an independent risk factor of major adverse cardiovascular events (MACE) in patients with CAD undergoing revascularization, nevertheless, some others indicate that no impact [21][22][23][24][25][26][27][28] and even protective effect [29] of MetS exists in these patients.…”

Impaired Fasting Glucose Is the Major Determinant of the 20‐Year Mortality Risk Associated With Metabolic Syndrome in Nondiabetic Patients With Stable Coronary Artery Disease

“…Furthermore, the follow‐up period in most studies about MetS or its components and mortality prediction in patients with CAD is <3 years 12, 17, 21, 22, 23, 24. Most studies explored cardiovascular mortality rather than all‐cause mortality as the primary outcome 12, 17, 21, 22, 23, 24…”

“…Most studies explored cardiovascular mortality rather than all‐cause mortality as the primary outcome 12, 17, 21, 22, 23, 24…”