Metabolic syndrome and risk of restenosis in patients undergoing percutaneous coronary intervention

被引:35
作者
Wouterjukema, J
Monraats, PS
Zwinderman, AH
De Maat, MPM
Kastelein, JJP
Doevendans, PAF
De Winter, RJ
Tio, RA
Frants, RR
Van der Laarse, A
Van der Wall, EE
Jukema, JW
机构
[1] Leiden Univ, Med Ctr, Dept Cardiol, NL-2300 RC Leiden, Netherlands
[2] Acad Med Ctr, Dept Vasc Med, Amsterdam, Netherlands
[3] ICIN, Utrecht, Netherlands
[4] Acad Med Ctr, Dept Med Stat, Amsterdam, Netherlands
[5] Erasmus Univ, Med Ctr, Dept Hematol, Rotterdam, Netherlands
[6] Univ Med Ctr, Dept Cardiol, Utrecht, Netherlands
[7] Acad Med Ctr, Dept Cardiol, Amsterdam, Netherlands
[8] Acad Hosp Groningen, Dept Cardiol, Groningen, Netherlands
[9] Leiden Univ, Med Ctr, Ctr Human & Clin Genet, Dept Human Genet, Leiden, Netherlands
关键词
D O I
10.2337/diacare.28.4.873
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - Patients with metabolic syndrome have increased risk of cardiovascular events. The number of patients With Metabolic syndrome is rapidly increasing, and these patients Often need revascularization. However, only limited data are available on the effect of metabolic syndrome on restenosis in patients undergoing percutaneous coronary intervention (PCI). RESEARCH DESIGN AND METHODS - To assess the role of trieLabolic syndrome in the development of restenosis, we performed an analysis in a population of patients from the GENetic DEterininants of Restenosis (GENDER) study. The GENDER project, a multicenter prospective study, included consecutive patients after successful PCI and was designed to study the predictive value of various genetic and other risk factors for subsequent clinical restenosis, defined as target vessel revascularization (TVR) or combined end point of death, myocardial infarction, and TVR. This subpopulation of GENDER consisted of 901 patients, 448 of whom (49.7%) had metabolic syndrome. RESULTS - on multivariable Cox regression analysis, Controlling for age, sex, previous myocardial infarction, stent length, current smoking, and Statin therapy, there was no association between increased risk of TVR (hazard ratio 1.03 [95% CI 0.68-1.57]) or the combined end point (1.05 [0.71-1.55]) and the presence of metabolic syndrome. CONCLUSIONS - This study demonstrates that metabolic syndrome is not associated with TVR or the combined end point after PCI. Furthermore, accumulating characteristics of metabolic syndrome were neither associated with increased risk of TVR nor with the combined end point. Therefore, PCI has equal beneficial results in patients with or Without Metabolic syndrome. This is important information in light of the pandemic proportion of Metabolic syndrome that the medical community will face.
引用
收藏
页码:873 / 877
页数:5
相关论文
共 15 条
[1]   Current PTCA practice and clinical outcomes in the Netherlands: the real world in the pre-drug-eluting stent era [J].
Agema, WRP ;
Monraats, PS ;
Zwinderman, AH ;
de Winter, RJ ;
Tio, RA ;
Doevendans, PAFM ;
Waltenberger, J ;
de Maat, MPM ;
Frants, RR ;
Atsma, DE ;
van der Laarse, A ;
van der Wall, EE ;
Jukema, JW .
EUROPEAN HEART JOURNAL, 2004, 25 (13) :1163-1170
[2]   Which features of the metabolic syndrome predict the prevalence and clinical outcomes of angiographic coronary artery disease? [J].
Anderson, JL ;
Horne, BD ;
Jones, HU ;
Reyna, SP ;
Carlquist, JF ;
Bair, TL ;
Pearson, RR ;
Lappé, DL ;
Muhlestein, JB .
CARDIOLOGY, 2004, 101 (04) :185-193
[3]   Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) [J].
Cleeman, JI ;
Grundy, SM ;
Becker, D ;
Clark, LT ;
Cooper, RS ;
Denke, MA ;
Howard, WJ ;
Hunninghake, DB ;
Illingworth, DR ;
Luepker, RV ;
McBride, P ;
McKenney, JM ;
Pasternak, RC ;
Stone, NJ ;
Van Horn, L ;
Brewer, HB ;
Ernst, ND ;
Gordon, D ;
Levy, D ;
Rifkind, B ;
Rossouw, JE ;
Savage, P ;
Haffner, SM ;
Orloff, DG ;
Proschan, MA ;
Schwartz, JS ;
Sempos, CT ;
Shero, ST ;
Murray, EZ .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (19) :2486-2497
[4]   Clinical restenosis after coronary stenting: Perspectives from multicenter clinical trials [J].
Cutlip, DE ;
Chauhan, MS ;
Baim, DS ;
Ho, KKL ;
Popma, JJ ;
Carrozza, JP ;
Cohen, DJ ;
Kuntz, RE .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2002, 40 (12) :2082-2089
[5]  
Genuth S, 2003, DIABETES CARE, V26, P3160
[6]   Meta-analysis of the effect of diabetes on restenosis rates among patients receiving coronary angioplasty stenting [J].
Gilbert, J ;
Raboud, J ;
Zinman, B .
DIABETES CARE, 2004, 27 (04) :990-994
[7]   Definition of metabolic syndrome - Report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition [J].
Grundy, SM ;
Brewer, HB ;
Cleeman, JI ;
Smith, SC ;
Lenfant, C .
CIRCULATION, 2004, 109 (03) :433-438
[8]   WAIST CIRCUMFERENCE AS A MEASURE FOR INDICATING NEED FOR WEIGHT MANAGEMENT [J].
LEAN, MEJ ;
HAN, TS ;
MORRISON, CE .
BRITISH MEDICAL JOURNAL, 1995, 311 (6998) :158-161
[9]   Metabolic syndrome modifies the cardiovascular risk associated with angiographic coronary artery disease in women - A report from the Women's Ischemia Syndrome Evaluation [J].
Marroquin, OC ;
Kip, KE ;
Kelley, DE ;
Johnson, BD ;
Shaw, LJ ;
Merz, CNB ;
Sharaf, BL ;
Pepine, CJ ;
Sopko, G ;
Reis, SE .
CIRCULATION, 2004, 109 (06) :714-721
[10]   Intracoronary stenting and angiographic results:: Strut thickness effect on restenosis outcome (ISAR-STEREO-2) trial [J].
Pache, J ;
Kastrati, A ;
Mehilli, J ;
Schühlen, H ;
Dotzer, F ;
Hausleiter, J ;
Fleckenstein, M ;
Neumann, FJ ;
Sattelberger, U ;
Schmitt, C ;
Müller, M ;
Dirschinger, J ;
Schömig, A .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2003, 41 (08) :1283-1288