title: Metabolic syndrome is an independent predictor of cardiovascular events in high-risk patients with occlusive and aneurysmatic peripheral arterial disease.
abstract: OBJECTIVE
  Metabolic syndrome (MetSyn) is a well-known risk factor for cardiovascular (CV) disease in the general population; however, the additional predictive value for CV events in high-risk patients with peripheral arterial disease (PAD) is unknown. The aims of the current study were to assess and compare: (1) prevalence of MetSyn, and (2) predictive value of MetSyn for CV events, in patients with either occlusive or aneurysmatic PAD.
  
  
  METHODS
  We screened 2069 patients scheduled for lower occlusive arterial revascularization (n=1031) or abdominal aortic aneurysm repair (n=1038) for the presence of MetSyn. Adult Treatment Panel III report (ATP III) was used for defining MetSyn. Central obesity was defined as body-mass-index>30 kg/m2. Main outcomes were the occurrence of CV events and CV mortality during a median follow-up of 6 years (IQR 2-9 years).
  
  
  RESULTS
  Metabolic syndrome was diagnosed in 421 (41%) and 432 (42%) patients with occlusive and aneurysmatic PAD, respectively (p=0.72). Patients with occlusive or aneurysmatic PAD and MetSyn had an increased risk for the development of CV events, when compared to patients without MetSyn (27% vs. 18% and 27% vs. 19%, p<0.001, respectively). In occlusive and aneurysmatic PAD, MetSyn was independently associated with an increased risk of CV events (HR=1.6; 95%CI 1.2-2.1 and HR=1.4; 95%CI 1.1-1.8). No significant association between the presence of MetSyn and CV mortality was observed.
  
  
  CONCLUSIONS
  Metabolic syndrome is highly prevalent in high-risk PAD patients. In occlusive and aneurysmatic PAD patients, MetSyn is an independent predictor of long-term CV events.
authors.affiliation: Department of Anesthesiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Jan-Peter
authors.initials: JP
authors.lastname: van Kuijk
authors.forename: Willem-Jan
authors.initials: WJ
authors.lastname: Flu
authors.forename: Michel
authors.initials: M
authors.lastname: Chonchol
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: Hence J M
authors.initials: HJ
authors.lastname: Verhagen
authors.forename: Don
authors.initials: D
authors.lastname: Poldermans
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000473:pathology*; D017544:Aortic Aneurysm, Abdominal / Q000628:therapy; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000175:diagnosis; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000175:diagnosis; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome