Long-term prognostic implications of metabolic syndrome in heart transplant recipients
I J Sánchez-Lázaro1, J M Sánchez-Gómez, L Almenar-Bonet
1Heart Failure and Transplantation Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain. ignaciosanchezlazaro@gmail.com
Insights
Metabolic syndrome (MS) is common after heart transplantation (HTx), affecting nearly 50% of patients. While not significant in this study, MS may impact long-term survival in HTx recipients.
Area of Science:
- Cardiology
- Transplantation Medicine
- Metabolic Disorders
Background:
- Metabolic syndrome (MS) is linked to cardiovascular events via endothelial dysfunction.
- Limited research exists on MS impact on heart transplantation (HTx) patient survival.
Purpose of the Study:
- To investigate the early and long-term effects of MS on survival post-heart transplantation.
- To assess the prevalence and prognostic implications of MS in HTx patients.
Main Methods:
- A cohort of 196 HTx patients with at least 1-year survival was studied.
- MS diagnosis (≥3 criteria: high triglycerides, low HDL-C, diabetes, hypertension, or obesity) was made 3 months post-HTx.
- Kaplan-Meier analysis assessed long-term survival; t-tests and chi-square tests compared groups.
Main Results:
- 96 out of 196 patients developed MS.
- MS patients were older, had higher creatinine, BMI, and pre-HTx hypertension and dyslipidemia.
- Long-term survival was numerically better in the non-MS group, but the difference was not statistically significant (P=.34).
Conclusions:
- MS is a frequent complication, developing in nearly 50% of HTx patients early post-transplant.
- The long-term prognostic impact of MS on overall survival warrants further investigation.
Background:
Metabolic syndrome (MS) increases the risk of cardiovascular events due to endothelial dysfunction. There are few studies evaluating the impact of MS on the survival of heart transplantation (HTx) patients.
Aim:
The aim of this study was to study the impact of MS in the early period and on the long-term survival after HTx.
Materials And Methods:
We studied 196 HTx patients with a minimum survival of 1 year post-HTx. A diagnosis of MS was made at 3 months after HTx, if at least 3 of the following criteria were met: triglyceride levels ≥150 mg/dL (or drug treatment for hypertriglyceridemia); high-density lipoprotein cholesterol (HDL-C) <40 mg/dL in men and <50 mg/dL in women (or drug treatment to raise HDL-C levels); diabetes mellitus on drug treatment or fasting glucose levels ≥100 mg/dL; blood pressure ≥130/85 mm Hg (or on antihypertensive drug treatment); and body mass index (BMI) ≥30. We used the Kaplan-Meier method (log-rank test) to calculate long-term survival and Student t and chi-square tests for comparisons.
Results:
Among 196 patients, 96 developed MS. There were no differences between the groups with versus without MS in recipient gender, underlying etiology, smoking, pre-HTx diabetes, or immunosuppressive regimen. However, differences were observed between groups in age (MS: 53 ± 9 vs non-MS: 50 ± 12 years; P = .001); pre-HTx creatinine (MS: 1.2 ± 0.3 vs non-MS: 1.0 ± 0.4 mg/dL; P = .001); BMI (MS: 27.3 ± 4 vs non-MS: 24.6 ± 4; P = .001); pre-HTx hypertension (MS: 48% vs non-MS: 17%; P < .001); and dyslipidemia (MS: 53% vs non-MS: 37%; P = .023). Long-term survival was better among the non-MS group, but the difference did not reach significance (MS: 2381 ± 110 vs non-MS: 2900 ± 110 days; P = .34).
Conclusions:
The development of MS early after HTx is a common complication that affects nearly 50% of HTx patients. The prognostic implication of this syndrome on overall survival might occur in the long term.
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