Metabolic Syndrome and Risk of Restenosis in Patients Undergoing Percutaneous Coronary Intervention

Author:

Rana Jamal S.12,Monraats Pascalle S.13,Zwinderman Aeilko H.4,de Maat Moniek P.M.5,Kastelein John J.P.2,Doevendans Pieter A.F.6,de Winter Robbert J.7,Tio René A.8,Frants Rune R.9,van der Laarse Arnoud1,van der Wall Ernst E.1,Jukema J. Wouter13

Affiliation:

1. Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands

2. Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands

3. Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, the Netherlands

4. Department of Medical Statistics, Academic Medical Center, Amsterdam, the Netherlands

5. Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands

6. Department of Cardiology, University Medical Center, Utrecht, the Netherlands

7. Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands

8. Department of Cardiology, Academic Hospital Groningen, Groningen, the Netherlands

9. Department of Human Genetics, Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands

Abstract

OBJECTIVE—Patients with metabolic syndrome have increased risk of cardiovascular events. The number of patients with metabolic syndrome is rapidly increasing, and these patients often need revascularization. However, only limited data are available on the effect of metabolic syndrome on restenosis in patients undergoing percutaneous coronary intervention (PCI). RESEARCH DESIGN AND METHODS—To assess the role of metabolic syndrome in the development of restenosis, we performed an analysis in a population of patients from the GENetic DEterminants of Restenosis (GENDER) study. The GENDER project, a multicenter prospective study, included consecutive patients after successful PCI and was designed to study the predictive value of various genetic and other risk factors for subsequent clinical restenosis, defined as target vessel revascularization (TVR) or combined end point of death, myocardial infarction, and TVR. This subpopulation of GENDER consisted of 901 patients, 448 of whom (49.7%) had metabolic syndrome. RESULTS—On multivariable Cox regression analysis, controlling for age, sex, previous myocardial infarction, stent length, current smoking, and statin therapy, there was no association between increased risk of TVR (hazard ratio 1.03 [95% CI 0.68–1.57]) or the combined end point (1.05 [0.71–1.55]) and the presence of metabolic syndrome. CONCLUSIONS—This study demonstrates that metabolic syndrome is not associated with TVR or the combined end point after PCI. Furthermore, accumulating characteristics of metabolic syndrome were neither associated with increased risk of TVR nor with the combined end point. Therefore, PCI has equal beneficial results in patients with or without metabolic syndrome. This is important information in light of the pandemic proportion of metabolic syndrome that the medical community will face.

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

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