Long-term outcomes in non-diabetic patients with metabolic syndrome undergoing revascularization for multi-vessel

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Leonid Yatskar1, Elizabeth Holper, Sameer Bansilal

  • 1New York University School of Medicine, New York, NY, United States.

Atherosclerosis
|December 7, 2007
PubMed

Insights

Metabolic syndrome (MS) predicts diabetes development in non-diabetic patients with multi-vessel coronary artery disease (MV-CAD). However, MS did not increase long-term mortality or myocardial infarction (MI) risk after revascularization.

Area of Science:

  • Cardiology
  • Metabolic Diseases
  • Clinical Research

Background:

  • The impact of metabolic syndrome (MS) on long-term outcomes in patients with multi-vessel coronary artery disease (MV-CAD) remains uncertain.
  • Understanding these risks is crucial for guiding treatment strategies in this patient population.

Purpose of the Study:

  • To investigate the influence of metabolic syndrome (MS) on long-term mortality and morbidity in non-diabetic (NDM) patients with MV-CAD.
  • To assess the impact of MS on the development of diabetes and subsequent cardiovascular events after coronary revascularization.

Main Methods:

  • Analysis of data from the Bypass Angioplasty Revascularization Investigation (BARI) trial and registry.
  • Patients were categorized into diabetic (DM) and non-diabetic (NDM) groups.
  • NDM patients were further classified based on the presence and number of metabolic syndrome (MS) components using the NCEP definition, with 10-year follow-up data analyzed using Cox proportional hazard modeling.

Main Results:

  • Metabolic syndrome (MS) and a 'mixed group' (2 MS components) were associated with a higher incidence of diabetes development over 10 years in NDM patients.
  • Type 2 diabetes was strongly linked to increased 10-year mortality.
  • Crucially, no statistically significant difference in death or myocardial infarction (MI) rates was observed at 5 and 10 years between NDM patients with or without MS.

Conclusions:

  • Metabolic syndrome (MS) effectively predicts the future development of diabetes in non-diabetic patients with multi-vessel coronary artery disease (MV-CAD).
  • Despite predicting diabetes, MS was not associated with increased long-term mortality or myocardial infarction (MI) risk in NDM patients undergoing revascularization.
  • Further research is warranted to fully understand the implications of MS in MV-CAD patients undergoing coronary revascularization.
Abstract

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