title: Prognostic usefulness of metabolic syndrome compared with diabetes in Korean patients with critical lower limb ischemia treated with percutaneous transluminal angioplasty.
abstract: OBJECTIVE
  Metabolic syndrome (MS) is a clinical condition that shares many common characteristics with diabetes. However, unlike diabetes, the usefulness of MS as a prognostic entity in peripheral arterial disease is uncertain. This study evaluated the prognostic usefulness of MS in critical lower limb ischemia (CLI) patients.
  
  
  METHODS
  We compared the 2-year clinical outcomes in 101 consecutive CLI patients (66±14 years; 78% men) with 118 affected limbs treated with percutaneous transluminal angioplasty (PTA) according to the presence of MS and diabetes.
  
  
  RESULTS
  The number of MS patients was 53 (52%), of which 45 (85%) had diabetes. During a 2-year follow-up, the incidence of clinical outcomes, including reintervention, major amputation, minor amputation, and survival, was not significantly different between MS and non-MS patients; however, the incidence of minor amputation was significantly higher in diabetic than in non-diabetic patients (42% vs. 17%; p=0.011). Cox regression analysis for the 2-year primary patency demonstrated no association between MS and 2-year primary patency [hazard ratio (HR), 1.02; 95% confidence interval (CI), 0.45-2.30; p=0.961], whereas there was a significant association between diabetes and 2-year primary patency (HR, 2.81; 95% CI, 1.02-7.72; p=0.046). Kaplan-Meier analysis revealed no significant difference in the 2-year primary patency between MS and non-MS patients; however, the 2-year primary patency was lower in diabetic than in non-diabetic patients (p=0.038).
  
  
  CONCLUSIONS
  As a prognostic concept, MS might conceal the adverse impact of diabetes on the prognosis of CLI patients treated with PTA.
authors: Department of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. cdhlyj@yuhs.ac.
authors: Ki-Bum
authors: KB
authors: Won
authors: Hyuk-Jae
authors: HJ
authors: Chang
authors: Sung-Jin
authors: SJ
authors: Hong
authors: Young-Guk
authors: YG
authors: Ko
authors: Myeong-Ki
authors: MK
authors: Hong
authors: Yangsoo
authors: Y
authors: Jang
authors: Donghoon
authors: D
authors: Choi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods*; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000628:therapy*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D024821:Metabolic Syndrome / Q000628:therapy*; D008875:Middle Aged; D056910:Republic of Korea; D012189:Retrospective Studies
keywords: Metabolic syndrome; angioplasty; critical limb ischemia; diabetes