Metabolic Syndrome and Risk of Restenosis in Patients Undergoing Percutaneous Coronary Intervention

  1. Jamal S. Rana, MD12,
  2. Pascalle S. Monraats, MSC13,
  3. Aeilko H. Zwinderman, PHD4,
  4. Moniek P.M. de Maat, PHD5,
  5. John J.P. Kastelein, MD, PHD2,
  6. Pieter A.F. Doevendans, MD, PHD6,
  7. Robbert J. de Winter, MD, PHD7,
  8. René A. Tio, MD, PHD8,
  9. Rune R. Frants, PHD9,
  10. Arnoud van der Laarse, PHD1,
  11. Ernst E. van der Wall, MD, PHD1 and
  12. J. Wouter Jukema, MD, PHD13
  1. 1Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
  2. 2Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
  3. 3Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, the Netherlands
  4. 4Department of Medical Statistics, Academic Medical Center, Amsterdam, the Netherlands
  5. 5Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands
  6. 6Department of Cardiology, University Medical Center, Utrecht, the Netherlands
  7. 7Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands
  8. 8Department of Cardiology, Academic Hospital Groningen, Groningen, the Netherlands
  9. 9Department of Human Genetics, Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands
  1. Address correspondence and reprint requests to J.W. Jukema, MD, PhD, FESC, FACC, Leiden University Medical Center, Department of Cardiology, C5-P, P.O. Box 9600, 2300 RC Leiden, Netherlands. E-mail: j.w.jukema{at}lumc.nl

Abstract

OBJECTIVE—Patients with metabolic syndrome have increased risk of cardiovascular events. The number of patients with metabolic syndrome is rapidly increasing, and these patients often need revascularization. However, only limited data are available on the effect of metabolic syndrome on restenosis in patients undergoing percutaneous coronary intervention (PCI).

RESEARCH DESIGN AND METHODS—To assess the role of metabolic syndrome in the development of restenosis, we performed an analysis in a population of patients from the GENetic DEterminants of Restenosis (GENDER) study. The GENDER project, a multicenter prospective study, included consecutive patients after successful PCI and was designed to study the predictive value of various genetic and other risk factors for subsequent clinical restenosis, defined as target vessel revascularization (TVR) or combined end point of death, myocardial infarction, and TVR. This subpopulation of GENDER consisted of 901 patients, 448 of whom (49.7%) had metabolic syndrome.

RESULTS—On multivariable Cox regression analysis, controlling for age, sex, previous myocardial infarction, stent length, current smoking, and statin therapy, there was no association between increased risk of TVR (hazard ratio 1.03 [95% CI 0.68–1.57]) or the combined end point (1.05 [0.71–1.55]) and the presence of metabolic syndrome.

CONCLUSIONS—This study demonstrates that metabolic syndrome is not associated with TVR or the combined end point after PCI. Furthermore, accumulating characteristics of metabolic syndrome were neither associated with increased risk of TVR nor with the combined end point. Therefore, PCI has equal beneficial results in patients with or without metabolic syndrome. This is important information in light of the pandemic proportion of metabolic syndrome that the medical community will face.

Footnotes

  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted December 30, 2004.
    • Received November 16, 2004.
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  1. doi: 10.2337/diacare.28.4.873 Diabetes Care April 2005 vol. 28 no. 4 873-877
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