P212Advanced atherosclerosis as characterized by metabolic syndrome and correlation with reoperative coronary artery bypass graft surgery. A ten years study

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Purpose: Atherosclerosis is a chronic inflammatory disease characterized by infiltration of blood vessels by lipids and leukocytes. Evidences showed that among risk factors that promote atherosclerosis, the metabolic syndrome is a powerful and prevalent predictor of cardiovascular events. Prognosis following coronary artery bypass graft surgery depends on a variety of factors, and successful grafts typically last 8–15 years. Coronary re-operations are demanding procedures with an increased risk profile. The present study examines the correlation of metabolic syndrome in patients undergoing reoperative coronary artery bypass graft surgery.

Methods: We included 3670 patients undergoing coronary artery bypass graft surgery (3017 male (80.3%), 652(17.4%) female, mean age was 68.3(±14.1) years, mean BMI 31± 7 kg/ m2, diabetes 29.4%, hypertension 51.4%, triglycerides ≥150 mg/dl 45.5%. All the patients were hospitalized in our institution since 2003 and they underwent coronary artery bypass graft surgery. Metabolic syndrome diagnosed by a co-occurrence of 3 out of five of the following medical conditions: abdominal (central) obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low high-density cholesterol (HDL) levels. Statistical analyses were performed using SPSS software. (Version 21). P < 0.05 was considered statistically significant.

Results: A significant correlation (P<0.05) was found between metabolic syndrome (high levels of triglycerides, elevated blood pressure and elevated fasting plasma glucose) and reoperative coronary artery bypass graft surgery. Mortality was significantly higher in patients with metabolic syndrome (P<0.05), associated with higher frequency of postoperative complications (prolongation of hospitalization, respiratory failure, frequent infections, longer hospitalization in the intensive care unit)

Conclusions: Advanced atherosclerosis, characterized by metabolic syndrome, influences the outcome in patients undergoing coronary artery bypass graft surgery. Thus, such aspect should be considered to reduce mortality in patients undergoing such surgery.

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