Key Points
- To explore the impact of metabolic syndrome on long-term outcomes after percutaneous coronary intervention.
- Assessing 748 patients undergoing percutaneous coronary intervention (PCI)
- Classifying patients based on metabolic syndrome determined by NCEP-ATPIII criteria
- Using Kaplan-Meier and Cox proportional hazards models for analyses
- 88 total deaths (11.8%) observed with no significant group differences
- Cardiac events occurred in 25.5% of patients with metabolic syndrome compared to 15.6% without (HR 2.23; 95% CI 1.59-3.11; p<0.001)
- Presence of metabolic syndrome significantly increased cardiac event risk among PCI patients.
Structured PICO
Does the presence of metabolic syndrome increase the risk of long-term mortality and cardiac events in patients undergoing percutaneous coronary intervention?
PPopulation748 consecutive Japanese patients who underwent percutaneous coronary intervention (PCI) for objective evidence of myocardial ischemia or ischemic symptoms associated with significant angiographic stenosis.
IInterventionPresence of metabolic syndrome (MS) defined by modified NCEP-ATPIII criteria (using BMI ≥25 kg/m² for obesity).
CComparatorAbsence of metabolic syndrome.
OOutcomeAll-cause mortality and composite cardiac events (incidence of cardiac death and non-fatal acute coronary syndrome, including acute myocardial infarction and unstable angina pectoris) at a mean follow-up of 12.0±3.6 years.composite
In Japanese patients undergoing PCI, the presence of metabolic syndrome is an independent predictor of long-term cardiac events over a 12-year follow-up, highlighting the need for secondary prevention targeting its components.
Limitations
- Small number of clinical events related to the small sample size and the low risk of the patients.
- Increase in surveillance after PCI in both groups may have been associated with the smaller number of cardiac events.
- Observational in nature, meaning unknown confounders might have affected the outcomes.
- Differences in medication use at the time of PCI (ACE inhibitors, β-blockers, calcium-channel blockers, oral hypoglycemic agents) may have affected results.
- MS patients included more patients with type 2 diabetes mellitus or hypertension, which are established predictors for increased mortality and cardiac events.