Abstract 1993: Impact of Metabolic Syndrome on Post-Procedural Myocardial Infarction After Percutaneous Coronary Intervention
Background: Aim of this study was to address the impact of the metabolic syndrome (MetS) on post-procedural myocardial infarction (pMI) after percutaneous coronary intervention (PCI).
Methods: The first native coronary lesion treated with PCI per patient was analyzed. Exclusion criteria were any increase in Creatine phosphokinase (CPK) or creatine kinase-MB (CK-MB) above upper normal limit at baseline; left ventricular ejection fraction < 30%; renal failure with creatinine > 3 mg/dL. 142 patients with 142 lesions fulfilled the inclusion criteria. We identified MetS by the International Diabetes Federation definition [ethnicity/gender adjusted abdominal obesity measured by waist circumference plus two or more criteria]. CPK and CK-MB were measured at baseline and at 18 hours after PCI. pMI was defined as a post-procedural increase of CK-MB > 2 times above the upper normal limit. Using 64-slice MDCT before PCI, we also performed volumetric plaque analysis of the target lesion in 28 patients with MetS and in 25 patients with non-MetS.
Results: The prevalence of MetS was 70 among 142 patients (49.2%). There were no significant differences in procedural variables between the two groups. pMI was detected in 16% of patients with MetS and 3% of those with non-MetS (p = 0.007). On logistic regression analysis, after adjusted for confounding and coronary risk factors, only the prevalence of MetS remained independently correlated with pMI (OR 5.56, CI 1.06–29.1, p = 0.04). In the MDCT profile, soft plaque volume, fibrous plaque volume and total plaque volume were significantly larger in patients with MetS compared to those with non-MetS (175.7 vs 96.5 mm3, p = 0.002, 177.0 vs 114.7 mm3, p = 0.006, 379.2 vs 247.4 mm3, p = 0.005) respectively, and significantly correlated with post-procedural increase of CK-MB (r = 0.56, p < 0.0001, r = 0.48, p = 0.0003, r = 0.56, p < 0.0001), respectively.
Conclusions: MetS is significantly associated with pMI, which might be influenced by plaque characteristics of the target lesions.