title: Influence of metabolic syndrome on development of cardiac allograft vasculopathy in the transplanted heart.
abstract: BACKGROUND
  Cardiac allograft vasculopathy (CAV) is the main cause of graft failure and death 1 year after heart transplantation (HTx). Metabolic syndrome (MS) increases the risk of cardiovascular events by endothelial dysfunction. The purpose of this study was to determine if patients with MS developed a higher risk of CAV 1 year after HTx.
  
  
  METHODS
  Since January 2004 until April 2009, 155 HTx patients were recruited. Cardiopulmonary transplants were excluded (12 patients), as well as retransplants (5 patients), pediatric transplants (11 patients), patients who refused to participate (3 patients), and those who died during the first year (35 patients). The final analysis included 89 patients. MS was diagnosed when Adult Treatment Panel III modified and revised criteria were met, before HTx or after the first 3 months. CAV was diagnosed through intravascular ultrasound performed 1 month and 1 year after HTx. CAV was defined as an intimal thickening ≥ 0.5 mm in the follow-up with regard to the one of the basal study.
  
  
  RESULTS
  Development of CAV was significantly higher in patients with MS (59% vs. 19%, P<0.0001). Patients with more criteria of MS had a higher development of CAV: no criteria (4%); one criterion (4%); two criteria (47%); three criteria (62%); four criteria (75%); and five criteria (100%). Variables related to CAV in a multivariate analysis were MS (odds ratio [OR] 7.97; 95% confidence interval [CI]: 2.77-22.96; P<0.001), donor's age (OR 1.07; 95% CI: 1.01-1.13; P=0.019), low high-density lipoprotein cholesterol (OR 0.26; 95% CI: 0.09-0.71; P=0.009), and hypertriglyceridemia (OR 4.08; 95% CI: 1.45-11.50; P=0.008).
  
  
  CONCLUSIONS
  Presence of MS distinguishes a subgroup of patients with high risk of developing CAV. Narrow and personalized monitoring of these patients would be recommendable.
authors: Heart Failure and Transplant Unit, Department of Cardiology, La Fe University Hospital, Valencia, Spain. jumisag1@hotmail.com
authors: Juan Miguel
authors: JM
authors: Sánchez-Gómez
authors: Luis
authors: L
authors: Martínez-Dolz
authors: Ignacio
authors: I
authors: Sánchez-Lázaro
authors: Luis
authors: L
authors: Almenar
authors: Elena
authors: E
authors: Sánchez-Lacuesta
authors: Begoña
authors: B
authors: Muñoz-Giner
authors: Manuel
authors: M
authors: Portolés
authors: Miguel
authors: M
authors: Rivera
authors: Alfonso
authors: A
authors: Valera-Román
authors: Jose Ramón
authors: JR
authors: González-Juanatey
authors: David
authors: D
authors: Tejada-Ponce
authors: Jaime
authors: J
authors: Agüero
authors: Francisco
authors: F
authors: Buendía
authors: Antonio
authors: A
authors: Salvador
mesh_terms: D000328:Adult; D000367:Age Factors; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D006331:Heart Diseases / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014652:Vascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology
chemical_list: D008076:Cholesterol, HDL