title: The Impact of Metabolic Syndrome on Clinical Outcomes After Everolimus-Eluting Stent Implantation.
abstract: As it is controversial whether metabolic syndrome (MetS) affects cardiovascular outcomes in patients who underwent percutaneous coronary intervention (PCI), we investigated the impact of MetS on clinical outcomes in patients who underwent PCI with everolimus-eluting stents (EESs). Patients who underwent PCI with EESs from 2009 to 2013 were included in this single-center, prospective cohort study. A composite event consisted of repeat revascularization, nonfatal myocardial infarction, and cardiac death. Of 903 patients observed for 4.9 years (median 1.8 years), 570 were diagnosed with MetS. The MetS group displayed more severe coronary artery disease and underwent more extensive PCIs than did the non-MetS group. The overall composite event rate was not significantly different between the MetS and the non-MetS group (11.9% vs 13.2%, p = 0.572). Kaplan-Meier survival analysis showed no significant difference in the event-free survival of the composite event between the 2 groups (p = 0.700). A multivariable Cox regression analysis showed that MetS was not associated with the composite event, whereas total stent length, decreased renal function, diabetes, and the absence of abdominal obesity were associated with the composite event. Abdominal obesity was associated with decreased risk of the composite event, alleviating unfavorable clinical outcomes of patients with diabetes in the MetS group. In conclusion, MetS has no impact on the clinical outcomes of patients who underwent PCI with EESs, although the MetS group exhibited more severe coronary artery disease and underwent more extensive PCIs. The paradoxical association between obesity and favorable clinical outcomes may explain this result.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea; Department of Cardiology, Sungae Hospital, Seoul, South Korea.
authors.forename: Yonggu
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea. Electronic address: mdoim@hanyang.ac.kr.
authors.forename: Young-Hyo
authors.initials: YH
authors.lastname: Lim
authors.affiliation: Department of Cardiology, Hanyang University Guri Hospital, Guri City, South Korea.
authors.forename: Jeong-Hun
authors.initials: JH
authors.lastname: Shin
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea.
authors.forename: Jinkyu
authors.initials: J
authors.lastname: Park
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea.
authors.forename: Jinho
authors.initials: J
authors.lastname: Shin
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea.
authors.forename: Kyung-Soo
authors.initials: KS
authors.lastname: Kim
mesh_terms: D000970:Antineoplastic Agents; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000494:pharmacology; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus