title: Long-term effect of metabolic syndrome with and without diabetes mellitus on coronary revascularization in Japanese patients undergoing percutaneous coronary intervention.
abstract: BACKGROUND
  Metabolic syndrome (MS) plays a crucial role in the long-term prognosis and primary or secondary prevention of coronary artery disease, regardless of the presence or absence of diabetes mellitus (DM). We previously reported that after percutaneous coronary intervention (PCI), patients with MS had worse long-term outcome. However, there is no evidence indicating the importance of MS with and without DM on re-revascularization procedures in Japanese patients undergoing PCI.
  
  
  OBJECTIVE
  We hypothesized that MS patients without DM have an increased risk of re-revascularization following PCI.
  
  
  METHODS
  We classified 748 consecutive Japanese patients who had undergone PCI into 4 groups as follows: neither DM nor MS, DM alone, MS alone, and both DM and MS. Post-hoc analyses were conducted using prospectively collected clinical data. Multivariate Cox regression was used to evaluate the risk within each group for subsequent revascularization (repeat PCI and bypass surgery), adjusting for baseline covariates.
  
  
  RESULTS
  The progress of 321 (42.9%) patients without DM or MS, 109 (14.6%) patients with DM alone, 129 (17.2%) patients with MS alone, and 189 (25.3%) patients with both DM and MS was followed up for a mean duration of 12.0 ± 3.6 years. Patients with MS alone (hazard ratio: 1.38, 95% confidence interval: 1.01-1.89, P = 0.04) and those with both DM and MS (hazard ratio: 1.36, 95% confidence interval: 1.02-1.81, P = 0.04) had a significantly increased risk for revascularization.
  
  
  CONCLUSIONS
  The presence of MS significantly increased the risk for subsequent revascularization among Japanese patients who underwent PCI, regardless of the presence or absence of DM.
authors: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors: Akihisa
authors: A
authors: Nishino
authors: Takatoshi
authors: T
authors: Kasai
authors: Katsumi
authors: K
authors: Miyauchi
authors: Naohisa
authors: N
authors: Nakajima
authors: Takayuki
authors: T
authors: Yokoyama
authors: Ken
authors: K
authors: Yokoyama
authors: Takeshi
authors: T
authors: Kurata
authors: Hiroyuki
authors: H
authors: Daida
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D044466:Asian People / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000208:ethnology / Q000601:surgery / Q000628:therapy*; D003920:Diabetes Mellitus / Q000208:ethnology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D024821:Metabolic Syndrome / Q000208:ethnology*; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome