The impact of the metabolic syndrome on cardiovascular outcomes in patients undergoing percutaneous coronary intervention.

Abstract

Background: The effect of the metabolic syndrome (MetS) on cardiac outcomes has not been extensively studied in percutaneous coronary intervention (PCI) patients. Methods: We reviewed the MIG registry for all patients undergoing PCI between 2005-2018 where baseline data to define MetS were available. The MetS surrogate definition included the presence of ≥3 of obesity (body mass index >30 kg/m2), hypertension, dyslipidaemia, or diabetes. Long-term mortality in patients with and without MetS was obtained from the National Death Index. Results: Of 41,146 PCI patients, 29.7% had MetS, with increasing prevalence over time (p<0.001). Patients with MetS were older and were more likely to be women and have stable angina; whereas non-MetS patients more often presented with STEMI (35.7% vs 19%), cardiogenic shock (3.9% vs 1.7%) or cardiac arrest (4.3% vs 2.7%), p<0.001 for all. At 30-days, MetS patients had higher rates of myocardial infarction (2.2% vs 1.8%, p=0.013) without significant differences in target vessel revascularisation (2.4% vs 2.2%, p=0.23) or death (3.0% vs 3.4%, p=0.05). Long-term survival was lower in the presence of MetS. Conclusion: MetS was associated with a worse long-term survival compared with non-MetS counterparts after PCI.