Metabolic syndrome does not impact long-term survival in patients with acute myocardial infarction after successful percutaneous coronary intervention with drug-eluting stents.

Abstract

OBJECTIVE:

This study aimed to evaluate long-term survival according to the presence of metabolic syndrome (MS) in patients with acute myocardial infarction (AMI) undergoing successful percutaneous coronary intervention (PCI) with drug-eluting stents (DES).

BACKGROUND:

Despite the significance of coronary reperfusion in AMI, the prognostic impact of MS has been investigated under inconsistent reperfusion therapy in AMI patients.

METHODS AND RESULTS:

Three-year clinical outcomes, including all-cause death and the composite of cardiac death or myocardial infarction, were evaluated according to MS status for 963 patients with AMI treated with successful PCI with DES. This study included 494 subjects with MS (51%) and 469 subjects without MS (49%). The incidence of multivessel disease and the mean number of implanted stents were significantly higher in patients with MS than in patients with non-MS. The occurrence of all-cause death (5.9% vs. 6.4%, P = 0.789) and the composite outcomes (5.1% vs. 6.2%, P = 0.485) did not differ significantly between patients with and without MS. Cox regression models revealed that MS had no significant impact on all-cause death (hazard ratio [HR] 0.91; 95% confidence interval [CI] 0.55-1.52; P = 0.726) or the composite outcomes (HR 0.81; 95% CI 0.48-1.39; P = 0.448). Obesity was associated with a decreased risk of all-cause death and the composite outcomes among all MS components.

CONCLUSIONS:

No difference was observed in long-term survival according to the presence of MS in patients with AMI after successful PCI with DES. This suggests that reperfusion therapy using PCI with DES is equally beneficial in patients AMI with and without MS.

• Authors: Ki-Bum Won, Byeong-Keuk Kim, Hyuk-Jae Chang, Dong-Ho Shin, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Jong-Won Ha, Myeong-Ki Hong, Yangsoo Jang
• Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (Catheter Cardiovasc Interv) Vol. 83 Issue 5 Pg. 713-20 (Apr 01 2014) ISSN: 1522-726X [Electronic] United States
• PMID: 23934969 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Wiley Periodicals, Inc.

Topics

• Aged
• Drug-Eluting Stents
• Female
• Humans
• Incidence
• Kaplan-Meier Estimate
• Male
• Metabolic Syndrome (complications, diagnosis, mortality)
• Middle Aged
• Myocardial Infarction (complications, diagnosis, mortality, therapy)
• Obesity (complications, mortality)
• Patient Selection
• Percutaneous Coronary Intervention (adverse effects, instrumentation, mortality)
• Proportional Hazards Models
• Registries
• Risk Assessment
• Risk Factors
• Time Factors
• Treatment Outcome