Prevalence of metabolic syndrome in heart transplant patients: role of previous cardiopathy and years since the procedure--the TRACA study.
BACKGROUND
Metabolic syndrome (MS) is a cluster of cardiovascular risk factors highly prevalent in patients with ischemic heart disease (IHD), the main etiologic cause for heart transplantation (HT).


METHODS
Data for 111 HT patients of a single institution were collected. The assessment of MS was made, according to the ATP III criteria, when 3 of the following diagnostic criteria were present: waist circumference >102 cm (men) or >88 cm (women); triglycerides > or =150 mg/dl; HDL-cholesterol <40 mg/dl (men) or <50 mg/dl (women); blood pressure > or =130/85 mm Hg; and fasting glucose > or =110 mg/dl, or diabetes mellitus previously diagnosed. Renal function was assessed by glomerular filtration rate, as estimated by the MDRD abbreviated equation.


RESULTS
Mean age of the 111 HT patients was 63.0 (11.0) years and 101 (91.0%) were men. The median time since transplant was 7.0 (3.0 to 13.0) years, and IHD was the primary cause for HT (56.8%). The prevalence of MS was 42.3% and was statistically higher in patients with IHD prior to HT (52.4% vs 27.2%; p = 0.007). Patients with MS were older but had the same time of follow-up since their HT. An analysis of the sample in tertiles of years since HT showed that MS was more prevalent in subjects who received HT due to IHD only in the lowest and highest tertile. Fifty-three patients (47.7%) had abdominal obesity, 47 (43.2%) were overweight and 22 (19.8%) were obese; most patients with abdominal obesity were diagnosed with MS (82.6%). Multivariate analysis showed a strong association between abdominal obesity and MS (odds ratio [OR] 6.2, 95% confidence interval [CI] 1.9 to 19.8), even after adjustment for body mass index, and also showed an independent association of MS with severe renal dysfunction (OR 9.8; p = 0.02).


CONCLUSIONS
MS is highly prevalent in HT patients and abdominal obesity is the leading cause of this clustering. IHD status and time since HT are major determinants in the prevalence of MS in HT patients.
Cordero Fort
Alberto
A
Department of Cardiology and Cardiovascular Surgery, Clínica Universitaria de Navarra, Pamplona, Spain. acordero@unav.es
Gavira
Juan José
JJ
Alegría-Barrero
Eduardo
E
Castaño
Sara
S
Martín
Ana
A
Ubilla
Matías
M
Mastrobuoni
Stefano
S
Alegría Ezquerra
Eduardo
E
Herreros
Jesús
J
Rábago
Gregorio
G
D000368:Aged; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology; D007674:Kidney Diseases / Q000150:complications / Q000503:physiopathology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000150:complications / Q000601:surgery*; D009765:Obesity / Q000150:complications / Q000473:pathology; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012720:Severity of Illness Index; D013997:Time Factors