Abstract 3949: Metabolic Syndrome does not Impact Survival of Patients with Coronary Artery Disease
Introduction: Metabolic syndrome is a risk factor for the development of coronary artery disease and diabetes mellitus but the impact of metabolic syndrome on survival in patients with established coronary artery disease is uncertain.
Methods: We correlated long term survival with demographic and clinical variables in 3469 patients with coronary disease documented by cardiac catheterization performed between 1990 and 2004 in a Department of Veterans Affairs hospital. Mean age was 66.2, 98.4% were male and 43.1% had diabetes. Metabolic syndrome as defined by NCEP criteria was present in 789 patients (22.7% of the total population). Metabolic syndrome was present in 468 patients with diabetes (32%) and in 321 patients without diabetes (16%). Glucose was measured on the day of catheterization. Revascularization was performed in 2791 patients (80.4%). Percutaneous coronary intervention (PCI) was done in 1674 and coronary bypass (CABG) in 1117. Survival was determined by query of the social security death index. Cox regression was performed on the entire cohort and separately for PCI and CABG.
Results: All cause mortality was 33.3% and 41.5% at 5 and 10 years respectively (mean follow-up interval was 60.3 months). Mortality was predicted as follows: Metabolic syndrome, lipid variables, hypertension and drug treatment (beta blockers, aspirin and lipid lowering drugs) did not independently predict survival in multivariate analysis. Metabolic syndrome did not have an independent effect on survival in patients with or without diabetes irrespective of revascularization status even when the analysis was repeated with metabolic syndrome defined using glucose > 100 mg/dl as a cut-off.
Conclusion: Metabolic syndrome does not impact on survival in diabetic or non-diabetic patients with coronary artery disease treated by revascularization and drug therapy.