Metabolic syndrome and risk of restenosis in patients undergoing percutaneous coronary intervention.
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).


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.
Rana
Jamal S
JS
Department of Cardiology, Leiden University Medical Center, C5-P, P.O. Box 9600, 2300 RC Leiden, Netherlands.
Monraats
Pascalle S
PS
Zwinderman
Aeilko H
AH
de Maat
Moniek P M
MP
Kastelein
John J P
JJ
Doevendans
Pieter A F
PA
de Winter
Robbert J
RJ
Tio
René A
RA
Frants
Rune R
RR
van der Laarse
Arnoud
A
van der Wall
Ernst E
EE
Jukema
J Wouter
JW
D015906:Angioplasty, Balloon, Coronary; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000145:classification / Q000453:epidemiology; D023903:Coronary Restenosis / Q000453:epidemiology*; D023921:Coronary Stenosis / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking