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Related Experiment Videos

How deadly is the "deadly quartet"? A post-CABG evaluation.

D L Sprecher1, G L Pearce

  • 1Department of Cardiology, The Cleveland Clinic Foundation, Ohio 44195, USA. sprechd@ccf.org

Journal of the American College of Cardiology
|October 12, 2000
PubMed
Summary
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Metabolic risk factors significantly increase mortality after coronary artery bypass surgery (CABG). Clustering of these factors, especially in women, predicts poorer survival even after revascularization.

Area of Science:

  • Cardiovascular Surgery
  • Metabolic Syndrome
  • Clinical Outcomes Research

Background:

  • The
  • deadly quartet
  • (obesity, diabetes, hypertension, hypertriglyceridemia) is linked to coronary heart disease.
  • Its impact on survival post-coronary artery bypass surgery (CABG), particularly by gender, is not well-established.

Purpose of the Study:

  • To assess the predictive value of clustered metabolic risk factors for mortality after CABG.
  • To investigate the influence of gender on the relationship between metabolic risk clusters and survival.

Main Methods:

  • Analysis of 6,428 patients undergoing primary isolated CABG (1987-1992) with median 8-year follow-up.
  • Cox models evaluated all-cause mortality, incorporating metabolic risk factors as a sum (0-4).

Related Experiment Videos

  • Examined gender differences in survival related to metabolic risk clusters.

    • Main Results:

    • Increased number of metabolic risk factors significantly correlated with higher mortality (HR 1.64 for 1 factor to 3.95 for 4 factors).
    • Annualized mortality rose from 1% (no risk factors) to 3.3% (all four risk factors).
    • Hazard ratios for four risk factors were 2.58 in men and 13.39 in women; observed risk factor clustering was higher in women (21%) than men (10%).

    Conclusions:

    • Metabolic risk factor clustering occurs more than expected by chance, particularly in women.
    • Survival is reduced in patients with clustered metabolic risk factors, even after CABG revascularization.