TY - JOUR
TI - Impact of metabolic syndrome on clinical outcomes after new generation
drug-eluting stent implantation: The `obesity paradox' phenomenon is
still apparent
AU - Patsa, C.
AU - Toutouzas, K.
AU - Tsiamis, E.
AU - Tsioufis, C.
AU - Spanos,
AU - A.
AU - Karanasos, A.
AU - Michelongona, A.
AU - Tousoulis, D. and
AU - Stefanadis, C.
JO - Nutrition, Metabolism and Cardiovascular Diseases
PY - 2013
VL - 23
TODO - 4
SP - 307-313
PB - Elsevier Sci Ltd, Exeter, United Kingdom
SN - 0939-4753
TODO - 10.1016/j.numecd.2011.05.002
TODO - New generation drug-eluting stent; Metabolic syndrome; Obesity
TODO - Background and aim: New generation drug-eluting stents (DES) have
improved clinical outcomes. However, their impact on patients with
metabolic syndrome (MS) is still unclear as there is no sufficient data.
Therefore, we evaluated the impact of the new generation DES on patients
with an isolated lesion in the proximal segment of the left anterior
descending artery (pLAD) suffering from MS.
Methods and results: We evaluated 511 patients with a pLAD lesion. Of
these, 147 patients had MS. The major adverse cardiac events (MACE)
including death, non-fatal myocardial infarction (MI) and target lesion
revascularization (TLR) were defined as primary end points. Stent
thrombosis was also evaluated. MACEs had a trend to be higher in non-MS
group (8.24% vs 3.40%, p = 0.05) during 20 months mean follow-up
period. Rates of cardiac death (1.37% vs 0.68%, p = 0.67), non-fatal
MI (1.92% vs 0.0%, p = 0.20), TLR (4.94% vs 2.04% MS, p = 0.21) and
thrombosis (3.29% vs 1.36%, p = 0.36) were not significantly different
in non-MS and MS group. The Kaplane-Meier curve revealed: MS group:
96.59% vs non-MS group: 91.75% (p = 0.04). MS was a favorable
independent predictor for MACE (hazard ratio (HR) 0.34, 95% confidence
interval (CI) 0.12-0.93, p < 0.03). In addition, independent predictors
for MACE were BMI >= 30 kg/m(2) (HR 0.87 95% CI 0.79-0.96 p = 0.008)
and diabetes mellitus (HR 2.01 95% CI 0.99-4.11, p = 0.05).
Conclusion: The ‘obese paradox’ phenomenon is found in the era of new
generation DES. In order to investigate the underlying mechanism for
this phenomenon further studies are required. (C) 2011 Elsevier B.V. All
rights reserved.
ER -