Association between Metabolic Syndrome and Pulmonary Arterial Hypertension

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<h3>Lead Author's Financial Disclosures</h3> Nothing to disclose. <h3>Study Funding</h3> None. <h3>Background/Synopsis</h3> Metabolic syndrome has been extensively studied to understand its consequences on systemic vascular system. Conversely, the significance of metabolic syndrome on pulmonary arterial system remains to be elucidated. The role of metabolic diseases in PAH has gained increasing interest in recent years. We conducted this study to identify the association and outcomes of metabolic syndrome in patients with PAH. <h3>Objective/Purpose</h3> To identify the association and outcomes of metabolic syndrome in patients with pulmonary arterial hypertension <h3>Methods</h3> We conducted a retrospective analysis of the 2016 to 2018 Nationwide Inpatient Sample. Adult patients with PAH and metabolic syndrome (age <b>≥</b>18) were selected using the ICD-10 diagnosis code. Discharge-level weight analysis was used to produce a national estimate. A univariate and multivariable hierarchal regression analysis was performed to calculate odds ratio (OR). <h3>Results</h3> During the study period, 90,902,481patients were hospitalized of which 150,095 (0.17%) had metabolic syndrome. Metabolic syndrome patients tended to be male (53.1% vs 57.8%), obese (64.0% vs 16.5%), hypertensive (46.1% vs 34.4%) and diabetic (58.5% vs 26.4%). Mean age was similar in both groups (57.7 SE 0.09 vs 57.9 SE 0.005). After adjusting for age, sex and comorbidity burden, metabolic syndrome increased the risk for PAH (OR 1.8; 1.2-2.8; p=0.006). Among those who developed PAH, metabolic syndrome was associated with higher risk of major adviser cardiac events (OR 3.6; 1.0- 12.5; p=0.04). However, in-hospital mortality (p=0.9), length of stay (p=0.4), acute coronary syndrome (p=0.1), acute respiratory failure (p=0.6) and acute heart failure (p=0.8) were not influenced by metabolic syndrome in PAH. <h3>Conclusions</h3> In conclusion, metabolic syndrome was associated with higher risk of pulmonary arterial hypertension. However, in-hospital mortality, complications and length of stay were not affected. Further studies are needed to explicate the association of metabolic syndrome and PAH as well as to develop potentially effective therapies.