title: Metabolic syndrome is an independent risk factor for stroke and acute renal failure after coronary artery bypass grafting.
abstract: OBJECTIVE
  Metabolic syndrome is common among patients having coronary artery bypass grafting. However, it remains unclear whether it has a significant impact on postoperative complications. We aimed to determine whether metabolic syndrome negatively influences the postoperative outcomes of coronary artery bypass grafting.
  
  
  METHODS
  We enrolled 1183 patients who had coronary artery bypass grafting at Juntendo University Hospital between 1984 and 1992. Patients were categorized by the presence or absence of metabolic syndrome using the modified National Cholesterol Education Program Adult Treatment Panel III definition with body mass index in the place of waist circumference. Multivariate analysis was performed to assess the relationships between preoperative presence of metabolic syndrome and postoperative outcomes.
  
  
  RESULTS
  Metabolic syndrome was present in 551 (46.6%) patients and absent in 632 (53.4%). Postoperative stroke occurred in 4.7% of patients with metabolic syndrome and 2.1% of patients without metabolic syndrome (P < .0001). Postoperative acute renal failure occurred in 3.8% of patients with metabolic syndrome and 1.1% of patients without metabolic syndrome. On multivariate analysis, metabolic syndrome had odds ratios of 2.47 (95% confidence interval 1.22-4.99; P = .012) for postoperative stroke and 3.81 (95% confidence interval 1.42-10.3; P = .008) for postoperative acute renal failure.
  
  
  CONCLUSIONS
  This study showed the clinical importance of metabolic syndrome with respect to postoperative stroke and acute renal failure in patients having coronary artery bypass grafting. Like many established risk factors for postoperative complications, metabolic syndrome should be recognized as a novel risk factor for adverse events.
authors.affiliation: Department of Cardiovascular Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Kan
authors.initials: K
authors.lastname: Kajimoto
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.forename: Naotake
authors.initials: N
authors.lastname: Yanagisawa
authors.forename: Taira
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Keita
authors.initials: K
authors.lastname: Kikuchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakatomi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwamura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
authors.forename: Atsushi
authors.initials: A
authors.lastname: Amano
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012307:Risk Factors; D020521:Stroke / Q000209:etiology*