Será a Síndrome Metabólica um Marcador de Prognóstico em Doentes com Elevado Risco Cardiovascular? Um Estudo de Coorte a Longo Prazo

• Autor(a) principal: Timóteo, AT
• Data de Publicação: 2019
• Outros Autores: Mota Carmo, M, Soares, C, Cruz Ferreira, R
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/3437
• topic: Adult; Aged; Aged, 80 and over; Biomarkers; Cardiovascular Diseases; Cause of Death; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Incidence; Lipids; Male; Metabolic Syndrome; Middle Aged; Portugal; Prognosis; Retrospective Studies; Risk Factors; Survival Rate; Time Factors; HSM CAR

INTRODUCTION: Obese patients are at higher cardiovascular risk in primary prevention. In secondary prevention, an obesity paradox has been reported. We analyzed a cohort of individuals from a previous cross-sectional study on the impact of metabolic syndrome (MS) on coronary artery disease (CAD), aiming to assess the occurrence of cardiovascular events in a long follow-up. METHODS: We analyzed 296 individuals in a mean follow-up of 6.9±2.2 years. Subjects were divided into four groups according to the presence of MS or CAD (defined as ≥70% coronary stenosis). RESULTS: The study population had a mean age of 65±9 years at the beginning of the study; 59.5% were male, 55.7% had MS and 41.6% had CAD. During follow-up 10.1% of the population suffered all-cause death, 3.7% cardiovascular death, 14.2% cardiovascular readmission and 22.0% the composite outcome (mortality, acute coronary syndrome, coronary revascularization, stroke/transient ischemic attack or heart failure admission). There were no significant differences in any type of mortality. Patients with CAD had more readmissions and composite outcomes (log-rank p<0.001 and p=0.001, respectively), but there was no difference according to the presence of MS. Only CAD was an independent predictor of cardiovascular admission (HR 3.21, 95% CI 1.66-6.21) and composite outcomes (HR 2.41, 95% CI 1.44-4.02). CONCLUSIONS: In patients with high cardiovascular risk or established CAD, the presence of MS is not associated with cerebral or cardiac events in long-term follow-up.