title: Long-term prognostic implications of metabolic syndrome in heart transplant recipients.
abstract: BACKGROUND
  Metabolic syndrome (MS) increases the risk of cardiovascular events due to endothelial dysfunction. There are few studies evaluating the impact of MS on the survival of heart transplantation (HTx) patients.
  
  
  OBJECTIVE
  The aim of this study was to study the impact of MS in the early period and on the long-term survival after HTx.
  
  
  METHODS
  We studied 196 HTx patients with a minimum survival of 1 year post-HTx. A diagnosis of MS was made at 3 months after HTx, if at least 3 of the following criteria were met: triglyceride levels ≥150 mg/dL (or drug treatment for hypertriglyceridemia); high-density lipoprotein cholesterol (HDL-C) <40 mg/dL in men and <50 mg/dL in women (or drug treatment to raise HDL-C levels); diabetes mellitus on drug treatment or fasting glucose levels ≥100 mg/dL; blood pressure ≥130/85 mm Hg (or on antihypertensive drug treatment); and body mass index (BMI) ≥30. We used the Kaplan-Meier method (log-rank test) to calculate long-term survival and Student t and chi-square tests for comparisons.
  
  
  RESULTS
  Among 196 patients, 96 developed MS. There were no differences between the groups with versus without MS in recipient gender, underlying etiology, smoking, pre-HTx diabetes, or immunosuppressive regimen. However, differences were observed between groups in age (MS: 53 ± 9 vs non-MS: 50 ± 12 years; P = .001); pre-HTx creatinine (MS: 1.2 ± 0.3 vs non-MS: 1.0 ± 0.4 mg/dL; P = .001); BMI (MS: 27.3 ± 4 vs non-MS: 24.6 ± 4; P = .001); pre-HTx hypertension (MS: 48% vs non-MS: 17%; P < .001); and dyslipidemia (MS: 53% vs non-MS: 37%; P = .023). Long-term survival was better among the non-MS group, but the difference did not reach significance (MS: 2381 ± 110 vs non-MS: 2900 ± 110 days; P = .34).
  
  
  CONCLUSIONS
  The development of MS early after HTx is a common complication that affects nearly 50% of HTx patients. The prognostic implication of this syndrome on overall survival might occur in the long term.
authors.affiliation: Heart Failure and Transplantation Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain. ignaciosanchezlazaro@gmail.com
authors.forename: I J
authors.initials: IJ
authors.lastname: Sánchez-Lázaro
authors.forename: J M
authors.initials: JM
authors.lastname: Sánchez-Gómez
authors.forename: L
authors.initials: L
authors.lastname: Almenar-Bonet
authors.forename: L
authors.initials: L
authors.lastname: Martínez-Dolz
authors.forename: B
authors.initials: B
authors.lastname: Muño-Giner
authors.forename: M
authors.initials: M
authors.lastname: Portolés-Sanz
authors.forename: E
authors.initials: E
authors.lastname: Roselló-Lleti
authors.forename: R
authors.initials: R
authors.lastname: Cortés-Vergaz
authors.forename: M
authors.initials: M
authors.lastname: Rivera-Otero
authors.forename: A
authors.initials: A
authors.lastname: Salvador-Sanz
mesh_terms: D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D016009:Chi-Square Distribution; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids