title: Relationship between the metabolic syndrome and the incidence of stroke after complete coronary revascularization over a 10-year follow-up period.
abstract: OBJECTIVE
  The prevalence of the metabolic syndrome, regarded as an important risk factor for coronary artery disease and stroke, is growing. However, the association between the metabolic syndrome and stroke, particularly in patients following coronary revascularization, remains unknown. Therefore, the relationship between the metabolic syndrome and stroke was examined among patients who had achieved complete coronary revascularization.
  
  
  METHODS
  1836 consecutive patients who had achieved complete revascularization from 1984 to 1992 were studied. The patients were categorized according to the presence or absence of the metabolic syndrome using the modified AHA/NHLBI statement (obesity was defined as a body mass index >or=25 kg/m(2)). Multivariate Cox proportional hazards regression was used for adjusted analyses for all-cause and cardiac mortality, as well as for the incidence of fatal and non-fatal stroke.
  
  
  RESULTS
  The progress of 826 (45.0%) patients with the metabolic syndrome and 1010 (55.0%) patients without the metabolic syndrome was analyzed. The mean follow-up was 11.4+/-2.9 years. Overall, there were 130 (7.1%) strokes, and the risk of stroke was significantly higher in patients with metabolic syndrome than in those without metabolic syndrome (HR 1.3; 95% CI 1.0-2.1; P=0.045).
  
  
  CONCLUSIONS
  The presence of the metabolic syndrome is a significant predictor of stroke, as well as all-cause and cardiac mortality, among patients who achieve complete coronary revascularization.
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Kan
authors.initials: K
authors.lastname: Kajimoto
authors.forename: Naozumi
authors.initials: N
authors.lastname: Kubota
authors.forename: Naotake
authors.initials: N
authors.lastname: Yanagisawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Amano
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000401:mortality; D008875:Middle Aged; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome