Background: Patients diagnosed with the metabolic syndrome (MS) have a higher risk for mortality. However, past studies examining the effects of the metabolic syndrome in post angiography patients were controversial in their results.
Objective: The aim of our study was to examine whether the presence of metabolic syndrome constitutes a risk factor for all-cause mortality in the largest cohort published of patients undergoing coronary angiography.
Materials and Methods: We recruited prospective patients referred for coronary angiography at our center. Medical history, physical examination and laboratory values were used to diagnose patients with the metabolic syndrome. Cox regression models were used to analyze the impact of metabolic syndrome on long term all-cause mortality.
Results: A total of 3529 consecutive patients were recruited. Their mean age was 66 ± 22 (range: 24-97 years), and 72% were males. A total of 495 deaths occurred during a mean follow-up period of 1614 ± 709 (median 1780 days IQR: 1030-2178 days) days. MS was associated with increased risk of death in the general cohort (HR=1.27, CI 95% 1.01-1.56, p=0.02). In patients with stable angina, there were 180 deaths (11%), while in the ACS group, 315 (17%) patients died (p<0.001). When we stratified the effect of the MS according to clinical presentation, we found that MS was significant in stable patients (HR=1.55, CI 95% 1.1-2.18, p=0.01) , while it was not significant in ACS patients (HR=1.11, CI 95% 0.86-1.44, p=0.42).
Conclusion: Metabolic syndrome is associated with increased mortality in post angiography patients. Its adverse outcome is mainly seen in patients with stable angina.
