Abstract

The metabolic syndrome (MS) is associated with higher incidence of cardiovascular events. However association between clustering of MS components and clinical outcomes after elective PCI was unclear. We prospectively evaluated 438 consecutive patients who underwent elective PCI with drug-eluting stents. The metabolic factors were defined according to NCEP-ATPIII definition except for west circumference (≥90cm for men and ≥80cm for women; ethnic specific value of Japanese). Patients were divided into three stratified groups according to MS factors (0 –1, 2–3 and 4 –5). Post-procedural myocardial injury was evaluated by analysis of troponin-T (TnT) 18 hours after PCI. Cardiac event was defined as the composite end-point of death of any cause, MI and revascularization. Number of MS factors significantly correlated with post-procedural TnT after adjusting for age, gender and coronary risk factors in multivariate regression analysis (beta-coefficient 0.122, t-value 2.224, p=0.03). Increased accumulation of MS factors is associated with higher post-procedural TnT and worse clinical outcomes after PCI (Figure ). In Cox proportional hazard models, the number of MS factors was a significant predictor of cardiac events after adjusting for age, gender and coronary risk factors (OR 1.397, 95%CI 1.174 –1.663, p<0.01) Accumulation of MS factors associated with worse clinical outcome even in patients treated with drug-eluting stents.

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