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Metabolic Syndrome is an Independent Risk Factor for Stroke and Acute Renal Failure after Coronary Artery Bypass Surgery
K. Kajimoto1, T. Kasai2, K. Miyauchi2, T. Yamamoto3, K. Kikuchi3, T. Nakatomi1, H. Iwamura1, H. Daida2, A. Amano3. 1Department of Cardiovascular Surgery, Juntendo University Shizuoka Hospital, Shizuoka, Japan, 2Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan, 3Department of Cardiovascular Surgery, Juntendo University School of Medicine, Tokyo, Japan,
BACKGROUND: Metabolic syndrome (MetS) is highly prevalent among patients undergoing coronary artery bypass surgery (CABG). However, it remains unclear whether MetS have a significant impact on postoperative complications after CABG. We assessed that the MetS could negatively influence the postoperative outcome of CABG.
METHODS: We retrospectively analyzed the data of 1183 consecutive patients who underwent an isolated CABG procedure. Of these patients, 551 (47%) patients met the modified National Cholesterol Education Program-Adult Treatment Panel III criteria for MetS. Multivariate regression analyses were performed to assess the relations between preoperative presence of MetS and postoperative outcomes.
RESULTS: The postoperative stroke after CABG surgery was 4.7% in patients with MetS and 1.9% in patients without MetS (p < 0.0001). The postoperative acute renal failure was 3.8% in patients with MetS and 1.1% in patients without MetS. After adjusting for other conventional risk factors, the odds ratios of operative stroke and acute renal failure were 2.49 (95% CI 1.22 - 5.09; p < 0.001) and 4.01 (95% CI 1.65 - 9.73; p < 0.001) respectively. However, there were no relationship between MetS and other postoperative outcomes including mortality, myocardial infarction, low output syndrome and mediasternitis.
CONCLUSIONS: This is the first study to shows the clinical importance of the presence of MetS with respect to postoperative adverse events in patients undergoing CABG. We should recognize MetS as a novel risk factor for operative stroke and acute renal failure, like many established risk factors for postoperative complications. 
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