Impact of metabolic syndrome on clinical outcomes after new generation drug-eluting stent implantation: the 'obesity paradox' phenomenon is still apparent.
Nutr Metab Cardiovasc Dis
; 23(4): 307-13, 2013 Apr.
Article
en En
| MEDLINE
| ID: mdl-21917434
ABSTRACT
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 ANDRESULTS:
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 Kaplan-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.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
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Síndrome Metabólico
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Stents Liberadores de Fármacos
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Intervención Coronaria Percutánea
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Obesidad
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Nutr Metab Cardiovasc Dis
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
CIENCIAS DA NUTRICAO
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METABOLISMO
Año:
2013
Tipo del documento:
Article
País de afiliación:
Grecia