The prognosis of coronary disease with different cardiovascular risk factors combined / 中华急诊医学杂志

ABSTRACT

Objective To assess the prevalence, and characteristics, and in-hospital and long-term prognosis of coronary artery disease (CAD) with metabolic syndrome, and to determine the factors affecting the prognosis of CAD most. Method The DESIRE (drug-eluting stent impact on revascularization) registry covered a database of 2368 patients with coronary artery disease (CAD) treated with percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in a period between July 2003 and September 2004. The median long-term follow-up time was 3.5 years ranged from 293 to 1855 days. The metabolic syndrome (MS) was diagnosed on the Definition of the Metabolic Syndrome modified by the Adult Treatment Panel (ATP) Ⅲ in 2005, by using the body mass index (BMI) instead of waist circumference. The relationship between metabolic syndrome (MS) and the incidences of major adverse cardiac as well as cerebral events (MACCE) in a large cohort of patients treated for revascularization was analyzed by using logistic analysis and Cox regression with SPSS 11.0 software. Results The Ms was present in 45.6% patients (high fast glucose (FG) in 44.5% patients, high triglycerides (TG) in 45.0% patients, low high density lipoprotein (HDL) in 50.8% patients, high BP in 61.4% patients, high BMI in60.7% patients). After follow-up, the ratio of MACCE in CAD patients with metabolic syndrome increased significantly (18.9% vs. 15.6%, P <0.036). The most dangerous factors of MS were high FG, hypertension and obesity (OR=1.787, 95%CI=1.132-2.845, P =0.014). Conclusions The MS contributes the high risk factors of MACCE in CAD patients with or without diabetes. The most dangerous combination of risk factors in MS is the combination of high FG, hypertension and obesity.