Impact of metabolic syndrome on clinical and angiographic outcome after sirolimus-eluting stent implantation

Background Patients with metabolic syndrome (MetS) are at increased risk of cardiovascular events. The impact of MetS on clinical events and restenosis after drug-eluting stent placement is not well defined. Methods Two hundred and seventy-four consecutive patients with 298 de-novo coronary lesions (< 50 mm lesion length, reference diameter < 3.5 mm) successfully treated with sirolimus-eluting stents (SES) were enrolled in the study. Bifurcation lesions, left main lesions and ST-segment elevation myocardial infarcts were excluded. Patients were categorized into three groups: (i) diabetes, (ii) MetS without diabetes, (iii) controls without MetS or diabetes. MetS was defined as presence of >= 3 of the following criteria: obesity, hypertension, hypertriglyceridemia, low high-density lipoprotein cholesterol, raised fasting glucose. Results One hundred and twenty-one patients (44%) with 134 lesions had neither MetS nor diabetes, 84 patients (31%) with 89 lesions had MetS without diabetes and 69 patients (25%) with 75 lesions had diabetes. Baseline angiographic parameters were comparable between the three groups. Clinically driven target lesion revascularization rates and major adverse cardiac event rates at 12 months were 1, 1, 7% (P= 0.039) and 3, 6 and 14% (P=0.032), respectively, for controls, patients with MetS/no diabetes and diabetic patients. Follow-up angiography at 6 months demonstrated late loss in lesion, which was 0.10 +/- 0.33 mm in the controls, 0.10 +/- 0.20 mm in patients with MetS/no diabetes and 0.36 +/- 0.66 mm in diabetic patients (P=0.009). Conclusion MetS without diabetes does not result in an increase in target lesion revascularization, major adverse cardiac event rates or angiographic late loss compared with control patients after implantation of SES in de-novo coronary lesions. Coron Artery Dis 18:601-606 (c) 2007 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.