PURPOSE: The clustering of several metabolic factors in a combination of high blood glucose, high blood pressure, high lipid profile and/or obesity are know to be metabolic syndrome which is a risk factor of coronary artery disease. Diabetes is a known risk factor of short- and long-term death after coronary artery bypass grafting (CABG). However, long-term results after CABG with metabolic syndrome with or without diabetes is unknown. Thus, we retrospectively investigated the survival after CABG in patients with metabolic syndrome classified by the presence or absence of diabetes.
METHODS: A total of 1183 isolated CABG was performed between 1984 and 1992, consecutively. Follow-up was completed by telephone interview or contacts with primary care physicians. Prior to surgery, 551 patients were met the criteria of metabolic syndrome, defined as 3 or more out of 5 following criteria; fasting blood glucose greeter than 100 mg/dl, body mass index greater than 25, triglycerides greater than 150 mg/dl, or blood pressure greater than 130/80 mm/Hg. The patients survival analysis was performed by Kaplan-Meier methods and compared between the patients with or without diabetes, defined fasting blood glucose greater than 126 mg/dl or a requirement of anti-diabetic treatment.
RESULTS: All patients were completed survey with a mean follow-up period of 10.5 years. Among the patients with metabolic syndrome, 372 patients were diabetic and 179 were not diabetic. 10 and 15 years survival were 66% and 42% in diabetes, respectively, 80% and 57% in non-diabetes (p<0.001). The survival rate of patients without diabetes but with metabolic syndrome was not significantly different from the patients without metabolic syndrome (10 and 15 years survival rate of 80% and 66%, respectively), p=0.28.
CONCLUSION: The long-term survival of patients with metabolic syndrome with diabetes was significantly worse than that without diabetes. However, patients with metabolic syndrome without diabetes are similar to the patients without metabolic syndrome.
CLINICAL IMPLICATIONS: Diabetes plays key role in the patients with metabolic syndrome in terms of long-term survival after CABG.
DISCLOSURE: Hitoshi Hirose, No Financial Disclosure Information; No Product/Research Disclosure Information