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

Tie, Hongtao; Shi, Rui; Li, Zhenhan; Zhang, Min; Zhang, Cheng; Wu, Qingchen

doi:10.1016/j.metabol.2015.06.019

Cited by 16 publications

(20 citation statements)

References 43 publications

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“…While most studies that evaluated patients after a recent acute coronary syndrome [14, 15, 30] or after coronary revascularization [16–21] failed to show a significant effects of MetS on mortality among patients with stable coronary artery disease and without revascularization, our study did find a significant association with all-cause mortality.…”

Section: Discussioncontrasting

confidence: 76%

“…[16–21] Furthermore these studies have explored the cardiovascular mortality rather than all-cause mortality as their primary outcome. [16–21]. …”

Section: Discussionmentioning

confidence: 99%

“…However, controversy remains regarding independent character of this association as well as regarding the additional value of the MetS in the risk estimation on top of its individual components. Furthermore, recent studies showed that MetS is associated with an increased risk of cardiovascular mortality and re-infarction in patients with cardiovascular disease [14, 15], however, these studies are mostly limited to patients after a recent acute coronary syndrome (ACS) or after revascularization, and there is limited data regarding patients with stable coronary disease without revascularization procedures [16]. Furthermore, to date the follow-up period in the majority of studies exploring the association of MetS and mortality is less than 3 years [16–21] and these studies have predominantly explored cardiovascular mortality and not all-cause mortality as their primary outcome [16–21].…”

Section: Introductionmentioning

confidence: 99%

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Metabolic syndrome is independently associated with increased 20-year mortality in patients with stable coronary artery disease

Younis

Tzur

et al. 2016

Cardiovasc Diabetol

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BackgroundData regarding long-term association of metabolic syndrome (MetS) with adverse outcomes are conflicting. We aim to determine the independent association of MetS (based on its different definitions) with 20 year all-cause mortality among patients with stable coronary artery disease (CAD).MethodsOur study comprised 15,524 patients who were enrolled in the Bezafibrate Infarction Prevention registry between February 1, 1990, and October 31, 1992, and subsequently followed-up for the long-term mortality through December 31, 2014. MetS was defined according to two definitions: The International Diabetes Federation (IDF); and the National Cholesterol Education Program–Third Adult Treatment Panel (NCEP).ResultsAccording to the IDF criteria 2122 (14%) patients had MetS, whereas according to the NCEP definition 7446 (48%) patients had MetS. Kaplan–Meier survival analysis showed that all-cause mortality was significantly higher among patients with MetS defined by both the IDF (67 vs. 61%; log rank-p < 0.001) as well as NCEP (67 vs. 54%; log rank-p < 0.001) criteria. Multivariate adjusted mortality risk was 17% greater [Hazard Ratio (HR) 1.17; 95% Confidence Interval (CI) 1.07–1.28] in patients with MetS according to IDF and 21% (HR 1.21; 95% CI 1.13–1.29) using the NCEP definition. Subgroup analysis demonstrated that long-term increased mortality risk associated with MetS was consistent among most clinical subgroups excepted patients with renal failure (p value for interaction < 0.05).ConclusionsMetabolic syndrome is independently associated with an increased 20-year all-cause mortality risk among patients with stable CAD. This association was consistent when either the IDF or NCEP definitions were used. Trial registration retrospective registeredElectronic supplementary materialThe online version of this article (doi:10.1186/s12933-016-0466-6) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 76%

“…[16–21] Furthermore these studies have explored the cardiovascular mortality rather than all-cause mortality as their primary outcome. [16–21]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Metabolic syndrome is independently associated with increased 20-year mortality in patients with stable coronary artery disease

Younis

Tzur

et al. 2016

Cardiovasc Diabetol

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“…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…”

mentioning

confidence: 99%

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

mentioning

confidence: 99%

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

Younis

Goldkorn

Goldenberg

et al. 2017

JAHA

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BackgroundWe wanted to explore the association of metabolic syndrome (MetS) versus its individual components with 20‐year all‐cause mortality among patients with stable coronary artery disease.Methods and ResultsThe cohort comprised 12 403 nondiabetic patients with stable coronary artery disease who were enrolled in the Bezafibrate Infarction Prevention Registry between February 1990 and October 1992 and followed up through December 2014. The study cohort was divided into 4 groups: patients without MetS or impaired fasting glucose (IFG), patients with IFG but without MetS, patients with MetS but without IFG, and patients with both MetS and IFG. Kaplan‐Meier survival analysis showed that at 20 years of follow‐up, the rates of all‐cause mortality were the highest among patients with both MetS and IFG (66%). Patients with IFG without MetS experienced a significantly higher mortality rate compared with those with MetS without IFG (61% versus 56%; log‐rank P<0.001). Multivariable Cox proportional hazard analysis showed that the final Cox model demonstrated that the additive effect of MetS (hazard ratio, 1.13; 95% confidence interval, 1.1–1.16; P=0.02) and IFG (hazard ratio, 1.54; 95% confidence interval, 1.46–1.62; P<0.001) on 20 years mortality was nonsignificant (hazard ratio, 1.01; 95% confidence interval, 0.93–1.11; P=0.69). IFG was associated with the most pronounced increase in mortality risk among the individual components (hazard ratio, 1.22; 95% confidence interval, 1.14–1.3; P<0.001).ConclusionsOur findings suggest that IFG alone is a major independent predictor of long‐term mortality among patients with stable coronary artery disease versus other components of the MetS.

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Association of metabolic syndrome with cardiovascular outcomes in hypertensive patients: a systematic review and meta-analysis

Liu

Chen

Cai

et al. 2021

J Endocrinol Invest

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PurposeThe association between metabolic syndrome (MetS) and cardiovascular outcomes in patients with hypertension is still controversial. This meta-analysis sought to evaluate the association of MetS with cardiovascular outcomes in hypertensive patients. Methods Two authors comprehensively searched PubMed and Embase databases from their inception to April 18, 2020 for the longitudinal studies that evaluated the association of MetS with cardiovascular outcomes in patients with hypertension. The main outcomes were major adverse cardiovascular events (myocardial infarction, revascularization, stroke, hospitalization due to heart failure, etc.) and stroke. Results Eight studies consisting of 36,614 hypertensive patients were identified and analyzed. Meta-analysis indicated that MetS was associated with an increased risk of major adverse cardiovascular events (risk ratio [RR] 1.55; 95% confidence intervals [CI] 1.28-1.87), cardiovascular mortality (RR 1.44; 95%CI 1.13-1.82), and stroke (RR 1.46; 95%CI 1.22-1.75), respectively. Sensitivity analysis further confirmed the robustness of the prognostic value of MetS. Conclusions MetS is associated with higher risk of major adverse cardiovascular events, cardiovascular mortality, and stroke in patients with hypertension. Determination of MetS may contribute to improving cardiovascular risk stratification in hypertension. KeywordsMetabolic syndrome • Hypertension • Major adverse cardiovascular events • Stroke * Y. Gong

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

Cited by 16 publications

References 43 publications

Metabolic syndrome is independently associated with increased 20-year mortality in patients with stable coronary artery disease

Metabolic syndrome is independently associated with increased 20-year mortality in patients with stable coronary artery disease

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

Association of metabolic syndrome with cardiovascular outcomes in hypertensive patients: a systematic review and meta-analysis

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