Metabolic syndrome is an independent risk factor for stroke and acute renal failure after coronary artery bypass grafting
Metabolic syndrome is an independent risk factor for stroke and acute renal failure after coronary artery bypass grafting
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DOI：
10.1016/j.jtcvs.2008.11.043
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发表时间：
2009-03-01
影响因子：
6
通讯作者：
Amano, Atsushi
中科院分区：
文献类型：
--
作者：
Kajimoto, Kan;Miyauchi, Katsumi;Amano, Atsushi
目的：代谢综合征在冠状动脉旁路移植术患者中很常见。然而，是否对术后并发症有显著影响尚不清楚。我们的目的是确定代谢综合征是否会对冠状动脉旁路移植术的术后结果产生负面影响。方法：1984年至1992年，在中山大学附属医院行冠状动脉旁路移植术的患者1183例。采用修改后的国家胆固醇教育计划成人治疗小组III定义，用腰围处的体重指数对患者进行代谢综合征的存在与否分类。进行多变量分析以评估术前代谢综合征的存在与术后预后之间的关系。结果：551例（46.6%）患者存在代谢综合征，632例（53.4%）患者无代谢综合征。有代谢综合征患者术后卒中发生率为4.7%，无代谢综合征患者术后卒中发生率为2.1% （P < 0.0001）。代谢综合征患者术后急性肾功能衰竭发生率为3.8%，无代谢综合征患者为1.1%。在多因素分析中，代谢综合征对术后卒中的比值比为2.47(95%可信区间1.22-4.99,P = 0.012)，对术后急性肾功能衰竭的比值比为3.81（95%可信区间1.42-10.3,P = 0.008）。结论：本研究显示了代谢综合征对冠状动脉旁路移植术患者术后卒中和急性肾功能衰竭的临床重要性。与许多已确定的术后并发症危险因素一样，代谢综合征应被视为不良事件的新危险因素。
Objectives: Metabolic syndrome is common among patients having coronary artery bypass grafting. However, it remains unclear whether it has a significant impact on postoperative complications. We aimed to determine whether metabolic syndrome negatively influences the postoperative outcomes of coronary artery bypass grafting.Methods: We enrolled 1183 patients who had coronary artery bypass grafting at Juntendo University Hospital between 1984 and 1992. Patients were categorized by the presence or absence of metabolic syndrome using the modified National Cholesterol Education Program Adult Treatment Panel III definition with body mass index in the place of waist circumference. Multivariate analysis was performed to assess the relationships between preoperative presence of metabolic syndrome and postoperative outcomes.Results: Metabolic syndrome was present in 551 (46.6%) patients and absent in 632 (53.4%). Postoperative stroke occurred in 4.7% of patients with metabolic syndrome and 2.1% of patients without metabolic syndrome (P < .0001). Postoperative acute renal failure occurred in 3.8% of patients with metabolic syndrome and 1.1% of patients without metabolic syndrome. On multivariate analysis, metabolic syndrome had odds ratios of 2.47 (95% confidence interval 1.22-4.99; P = .012) for postoperative stroke and 3.81 (95% confidence interval 1.42-10.3; P = .008) for postoperative acute renal failure.Conclusions: This study showed the clinical importance of metabolic syndrome with respect to postoperative stroke and acute renal failure in patients having coronary artery bypass grafting. Like many established risk factors for postoperative complications, metabolic syndrome should be recognized as a novel risk factor for adverse events.