Metabolic Syndrome Increases Risk of Postoperative Myocardial Infarction Following Percutaneous Nephrolithotomy.

Area of Science:

• Nephrology
• Cardiology
• Public Health

Background:

• Percutaneous nephrolithotomy (PCNL) is a primary treatment for large upper tract kidney stones.
• Metabolic syndrome (MetS), a cluster of conditions including diabetes, hypertension, dyslipidemia, and obesity, is linked to kidney stone formation.
• The cardiovascular risks associated with PCNL in patients with MetS are not well-defined.

Purpose of the Study:

• To assess the association between metabolic syndrome (MetS) and adverse cardiovascular outcomes following percutaneous nephrolithotomy (PCNL).
• To determine if the number of MetS components impacts the risk of postoperative myocardial infarction (MI) after PCNL.

Main Methods:

• A retrospective analysis of the Healthcare Cost and Utilization Project State Inpatient Database (2007-2011) for Florida and California.
• Patients undergoing PCNL were identified and categorized by the number of MetS components (0, 1-2, or 3-4).
• Postoperative myocardial infarction (MI) and in-hospital mortality were analyzed using multivariate logistic regression, controlling for patient characteristics and comorbidities.

Main Results:

• A total of 39,868 PCNL patients were analyzed; 6.7% had 3-4 MetS components.
• The incidence of postoperative MI increased with the number of MetS components (0: 0.6%; 1-2: 1.0%; 3-4: 1.8%; p < 0.001).
• Patients with 3-4 MetS components had a significantly increased odds of postoperative MI (OR 2.2, 95% CI 1.54-3.15; p < 0.001) compared to those with no MetS components.

Conclusions:

• Patients with metabolic syndrome exhibit a heightened risk of myocardial infarction after PCNL due to their existing comorbidities.
• Routine preoperative cardiac assessment may be beneficial for patients with MetS undergoing PCNL to mitigate cardiovascular risks.