Abstract 3532: The Metabolic Syndrome Increases Long-Term Mortality in Patients Following Surgical Complete Revascularization Over a 10-Year Follow-up Period
The metabolic syndrome (MetS) has been recognized as highly prevalent and associated with increased risk of mortality. However, the relationship between MetS and long-term prognosis after CABG remains unknown. We assess the hypothesis that MetS increases mortality in patients with surgical complete revascularization regardless of diabetes (DM).
Methods: We evaluated 1182 consecutive patients undergoing CABG. Patients were categorized by the presence or absence of MetS using the NCEP-ATP3 definition (for obesity we used a body mass index≤25 kg/cm2) and patients were divided into 4 subgroups based on the presence of DM. Multivariate analysis, adjusted for age, gender, choronic kidney disease, smoking, cerebral infarction, left ventricular ejection fraction, number of vessel disease, operative timing and using saphenous vein was performed to examine the risks for mortality among these groups.
Results: No metabolic abnormalities were present in 545 patients (46%). Metabolic abnormalities were present in 637 patients, including 247 with DM (with MetS; 160/ without MetS; 87) and 390 who had MetS without DM. The mean follow-up was 10.5 ±3.6 years. Overall, there were 343 all-cause and 106 cardiac death. Patients with both MetS and DM had the highest risks for all-cause and cardiac death (HR 2.46 (1.80–3.66), HR 5.27 (3.04–9.16), P<0.0001). Patients with MetS without DM also had higher risks comparing to patients without metabolic abnormalities (HR 1.42 (1.09–3.36), P=0.01, all-cause death and HR2.23 (1.33–3.75), P=0.002).
Conclusion: The presence of MetS significantly increased all-cause and cardiac death in patients undergoing CABG regardless of diabetes.