Özkan Sevil, Özdemir Fatih, Uğur Oğuz, Demirtunç Refik, Balci Ahmet Yavuz, Kizilay Mehmet, Vural Ünsal, Kaplan Mehmet, Yekeler Ibrahim
Department of Internal Medicine, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey. Email:
Department of Cardiovascular Surgery, Dr Siyami Ersek Training and Research Hospital on Thoracic and Cardiovascular Surgery, Istanbul, Turkey.
Cardiovasc J Afr. 2017;28(1):48-53. doi: 10.5830/CVJA-2016-056. Epub 2016 Jul 13.
The metabolic syndrome (MS) is a clustering of factors that are associated with increased cardiovascular risk. A low-grade inflammatory process acts as the underlying pathophysiology, which suggests that the MS may have a detrimental effect on coronary interventions, including coronary artery bypass grafting (CABG) surgery performed with cardiopulmonary bypass (CPB). We aimed to evaluate the effect of the MS on morbidity and mortality rates in the early postoperative period in patients undergoing CABG.
We prospectively included 152 patients (109 males and 43 females; mean age 60.1 ± 8.6 years) who underwent elective CABG on CPB between January and September 2011. Early postoperative morbidity and mortality rates were compared between subjects with and without the MS. Diagnosis of the MS was based on the American National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria.
Of the study group, 64 patients (42%) had the MS. The two groups were similar in age and gender. In the postoperative period, rates of atrial fibrillation, wound infection, pulmonary complications, and lengths of intubation, hospitalisation and intensive care unit stay were significantly higher in MS patients (p < 0.01). The MS was significantly associated with wound infection (OR 6.64, 95% CI: 1.72-25.75), pulmonary complications (OR 6.44, 95% CI: 1.58-26.33), arrhythmia (OR 5.47, 95% CI: 1.50-19.97) and prolonged intubation (OR 1.17, 95% CI: 1.05-1.32). The mortality rate was 3.1% in the MS group and 1.1% in the non-MS group, with no significant difference (p > 0.05).
The MS was associated with a higher rate of early postoperative morbidity following CABG, without having a significant effect on the mortality rate.
代谢综合征（MS）是一组与心血管风险增加相关的因素。低度炎症过程是其潜在的病理生理学机制，这表明MS可能对冠状动脉介入治疗有不利影响，包括在体外循环（CPB）下进行的冠状动脉旁路移植术（CABG）手术。我们旨在评估MS对接受CABG患者术后早期发病率和死亡率的影响。
我们前瞻性纳入了2011年1月至9月期间在CPB下行择期CABG的152例患者（109例男性和43例女性；平均年龄60.1±8.6岁）。比较有和没有MS的患者术后早期的发病率和死亡率。MS的诊断基于美国国家胆固醇教育计划成人治疗专家组第三次报告（NCEP ATP III）标准。
研究组中，64例患者（42%）患有MS。两组在年龄和性别方面相似。术后，MS患者的房颤、伤口感染、肺部并发症发生率以及插管时间、住院时间和重症监护病房停留时间均显著更高（p<0.01）。MS与伤口感染（比值比6.64，95%可信区间：1.72-25.75）、肺部并发症（比值比6.44，95%可信区间：1.58-26.33）、心律失常（比值比5.47，95%可信区间：1.50-19.97）和插管时间延长（比值比1.17，95%可信区间：1.05-1.32）显著相关。MS组的死亡率为3.1%，非MS组为1.1%，无显著差异（p>0.05）。
MS与CABG术后早期较高的发病率相关，但对死亡率无显著影响。
