Impact of metabolic syndrome and C-reactive protein on outcome after coronary stenting.
Metabolic syndrome (MS) identifies cardiovascular risk; however, there is little information regarding the evolution of patients with MS after stent implantation. The aim of this single-center study is to evaluate the possible association between MS and clinical restenosis, after adjustment for highsensitivity C-reactive protein (hs-CRP) and angiographic predictors of restenosis. In a longitudinal study, 159 patients (89 with and 70 without MS) were studied. Criteria for MS were: elevated blood pressure (systolic >or=130 mmHg, diastolic >or=85 mmHg or drug treatment for hypertension; elevated fasting glucose (>100 mg/dl) or drug treatment for elevated glucose; reduced HDL-cholesterol (<40 mg/dl in men and <50 mg/dl in women) or drug treatment for reduced HDL-cholesterol; elevated triglycerides (>or=150 mg/dl) or drug treatment for elevated triglycerides; and obesity (body mass index >28.8 kg/m2). The primary end point was the rate of major adverse clinical events (MACE): cardiovascular death, myocardial infarction, or target lesion revascularization (TLR) during the 12-month follow-up period. The secondary end point was the rate of TLR. MS was neither identified as predictor of MACE [hazard ratio (HR): 0.844; 95% CI: 0.41-1.74; p=0.648], nor TLR (HR: 1.05; 95% CI: 0.44-2.50; p=0.91), even when controlled for hs-CRP levels and angiographic predictors of restenosis. Also, no significant interaction between MS and hs-CRP was found (p=0.135 and p=0.194, for MACE and TLR, respectively). This study shows that patients with MS do not have an additional risk of MACE, even when controlled for angiographic predictors of restenosis and hs-CRP.
Iturry-Yamamoto
G R
GR
Hemodynamic Unit/Cardiology Division, Clinic Hospital of Porto Alegre (HCPA), Porto Alegre, RS, Brazil. iturryamamoto@yahoo.com
Zago
A C
AC
Moriguchi
E H
EH
Manfroi
W C
WC
Camargo
J L
JL
Gross
J L
JL
Zago
A J
AJ
D054058:Acute Coronary Syndrome / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D002097:C-Reactive Protein / Q000378:metabolism*; D023903:Coronary Restenosis / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D011379:Prognosis; D015607:Stents
D002097:C-Reactive Protein