代谢综合症增加冠状动脉旁路再造术的手术风险
J Am Coll Cardiol 2007;50:843-851Metabolic Syndrome Increases Operative Mortality in CABG Patients
NEW YORK (Reuters Health) Aug 24 - Metabolic syndrome is a "powerful" risk factor for operative mortality in patients undergoing coronary artery bypass graft (CABG) surgery, according to findings published in the August 28th Journal of the American College of Cardiology.
"This study illustrates that metabolic syndrome confers a global risk (from disease development to therapeutic interventions), and thus emphasizes that prevention is of crucial importance to reduce the impact of high-risk visceral obesity on cardiovascular health," Dr. Patrick Mathieu from Hopital Laval, Sainte-Foy, Quebec, Canada told Reuters Health.
Dr. Mathieu and colleagues investigated whether metabolic syndrome adversely affected the operative outcome in a retrospective study of 5304 patients who underwent an isolated CABG procedure between 2000 and 2004.
Nearly half the patients who underwent CABG surgery (46%) met criteria for metabolic syndrome.
Patients with metabolic syndrome experienced an age-adjusted 2.8-fold increase in the risk of operative mortality compared with patients without metabolic syndrome, the authors report. The actual operative mortality rates were 2.4% in metabolic syndrome patients and 0.9% in patients without metabolic syndrome.
The impact of metabolic syndrome on operative mortality was similar in men and women, the researchers found.
The investigators note that the five components of metabolic syndrome were not independently associated with increased operative mortality.
"The mechanism by which the metabolic syndrome confers a higher operative mortality and morbidity following CABG remains to be elucidated," Dr. Mathieu said. "However, we suspect that the pro-inflammatory condition associated with visceral obesity may play a role in this process."
"Decreasing the amount of abdominal fat is undoubtedly one target that would reduce the prevalence of metabolic syndrome and which would translate in better outcomes following CABG," Dr. Mathieu added. "However, whether life-style interventions and/or pharmacological approach can be implemented with success in patients who are planned for elective CABG remains to be studied."
感谢分享，辛苦了 [s:61]
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