The effect of the metabolic syndrome on the risk and outcome of coronary artery bypass graft surgery.
BACKGROUND
The individual components of the metabolic syndrome are risk factors for coronary artery disease. The underlying pathophysiology of a low-grade inflammatory process postulates that the metabolic syndrome could compromise a procedure such as coronary artery bypass graft surgery (CABG) done on cardiopulmonary bypass (CPB).


METHODS
From a single institution, 370 patients with the metabolic syndrome (IDF and ATP III criteria) and 503 patients without the metabolic syndrome were identified. The influence of the metabolic syndrome on the pre-operative core risk factors for CABG mortality as well as its effect on the mortality and major morbidity post surgery were investigated.


RESULTS
Patients with the metabolic syndrome were operated on less urgently than those without the metabolic syndrome. The EuroSCORE was also lower in those with the metabolic syndrome. Patients with the metabolic syndrome required fewer units of homologous red blood cells, but stayed statistically longer in hospital.


CONCLUSIONS
In this surgical population the metabolic syndrome had no detrimental clinical effect on either the pre-operative risk factors or the outcome after CABG.
Mediclinic Bloemfontein, South Africa. mjswart@ktc.bfnmcc.co.za
Marius J
MJ
Swart
Wihan H
WH
De Jager
Johann T
JT
Kemp
Paul J
PJ
Nel
Sarel L
SL
Van Staden
Gina
G
Joubert
D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome