Objectives: The metabolic syndrome is associated with high risk for long-term coronary artery disease mortality. However, few studies have examined the prognostic importance of the metabolic syndrome with and without hypertension.
Methods: The data of 1133 nondiabetic patients who underwent complete revascularization were analyzed. The patients were categorized by the presence of the metabolic syndrome using the modified American Heart Association/National Heart, Lung, and Blood Institute statement and by the presence of hypertension. All patients were divided into four groups: neither the metabolic syndrome nor hypertension (group 1); the metabolic syndrome without hypertension (group 2); hypertension without the metabolic syndrome (group 3); and both the metabolic syndrome and hypertension (group 4). Cox proportional hazards were used in adjusted analyses for all-cause and cardiac mortality, as well as for the composite incidence of fatal and nonfatal stroke.
Results: The progress of 276 (24.4%) patients in group 1, 413 (36.5%) in group 2, 105 (9.3%) in group 3, and 339 (29.9%) in group 4 was analyzed. The mean follow-up was 10.4 ± 3.4 years. Patients in group 4 had a higher risk of all-cause mortality (hazard ratio 1.78, P = 0.004). In addition, patients in groups 2 and 4 had a higher risk of cardiac mortality (group 2: hazard ratio 2.84, P = 0.04, group 4: hazard ratio 3.91, P = 0.001) and stroke (group 2: hazard ratio 2.46, P = 0.03, group 4: hazard ratio 2.09, P = 0.03).
Conclusion: The metabolic syndrome both with and without hypertension is associated with increased risk of cardiac mortality and stroke incidence in patients who underwent complete coronary revascularization.