Metabolic syndrome (M.S.) constitutes a cluster of risk factors for cardiovascular disease such as hypertriglyceridemia, hypertension, diabetes, central obesity and low high density lipoprotein levels. Any three of the above risk factors qualifies to be classified as M.S. Many patients undergoing cardiovascular surgical and percutaneous interventions may not have been diagnosed and treated adequately for this syndrome so as to prevent perioperative morbidity. The prevalence of M.S and postoperative complications has not been described adequately in literature.
All patients undergoing cardiovascular and thoracic surgery and percutaneous interventions at a specialty hospital over a 12 month period between June 2001 and June 2002 were included in the study. Data was collected on demographics, risk factors, lab data and diagnostics preoperatively and type of intervention and postoperative complications. Patients were classified as having metabolic syndrome with at least 3 or 4 or 5 risk factors. Analysis was performed using SPSS version 12.0.
Of the 312 patients, 68.6% were males and 31.4% females. M.S. was prevalent in 54.4% of patients with 33.3% having 3 risk factors, 14.4% having 4 risk factors and 6.7% having all 5 risk factors. Most frequent interventions were Percutaneous coronary interventions (27%), Endoluminal graft of aorta (16%), peripheral arterial interventions (15%), coronary artery bypass surgery (14%), abdominal aneurysm repair (11%), carotid endartectomy (10%) and femoral popliteal bypass surgery (5%). Most common postoperative complications include renal dysfunction (20%), blood transfusion requirement (17%), pleuropericardial effusion (12%), atrial fibrillation (7.4%), congestive heart failure (2%) and stroke (2%). Overall prevalence of complications was 42%.
1. Prevalence of metabolic syndrome is high in patients admitted to hospital for cardiothoracic and vascular surgical or percutaneous interventions. 2. Prevalence of postoperative complications is high in this high risk interventional procedure.
An opportunity exists to identify patients with metabolic syndrome preoperatively in cardiothoracic and vascular interventions (both surgical and percutaneously) and implement preventative therapeutic strategies to decrease postoperative morbidity and mortality.
K. Vijayaraghavan, None.