Impact of metabolic syndrome on short-term outcome of carotid revascularization: a large sample size study in Chinese population  

作　　者：Xue-Song Bai Yao Feng Tao Wang Xiao Zhang Chang-Lin Yang Ya-Bing Wang Yang Hua Jie Lu Feng-Shui Zhu Yan-Fei Chen Peng Gao Ren-Jie Yang Yan Ma Li-Qun Jiao 

机构地区：[1]China International Neuroscience Institute(China-INI),Beijing 100053,China [2]Department of Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China [3]Capital Medical University,Beijing 100053,China [4]Department of Vascular Ultrasonography,Xuanwu Hospital,Capital Medical University,Beijing 100053,China [5]'Department of Radiology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China [6]Department of Interventional Neuroradiology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China

出　　处：《Chinese Medical Journal》2020年第22期2688-2695,共8页中华医学杂志（英文版）

基　　金：The study was funded by grants from the National Key Research and Development Project(No.2016YFC1301703);the Beijing Scientific and Technologic Project(No.D161100003816002)。

摘　　要：Background:Metabolic syndrome(MetS)is relatively common worldwide and an important risk factor for cardiovascular diseases.It is closely linked to arterial stiffness of the carotid artery.However,the association of MetS with the safety of carotid revascularization has been rarely studied.The aim of this study was to observe the current status of MetS and its components in Chinese carotid revascularized patients,and investigate the impact on major adverse clinical events(MACEs)after carotid endarterectomy(CEA)or carotid artery stenting(CAS).Methods:From January 2013 to December 2017,patients undergoing CEA or CAS in the Neurosurgery Department of Xuanwu Hospital were retrospectively recruited.The changes in prevalence of MetS and each component with time were investigated.The primary outcome was 30-day post-operative MACEs.Univariable and multivariable analyses were performed to identify the impact of MetS on CEA or CAS.Results:A total of 2068 patients who underwent CEA(766 cases)or CAS(1302 cases)were included.The rate of MetS was 17.9%;the prevalence rate of MetS increased with time.The occurrence rate of MACEs in CEA was 3.4%(26 cases)and in CAS,3.1%(40 cases).There was no statistical difference between the two groups(3.4%vs.3.1%,P=0.600).For CEA patients,univariate analysis showed that the MACE(+)group had increased diabetes history(53.8%vs.30.9%,P=0.014)and MetS(34.6%vs.15.8%,P=0.023).For CAS patients,univariate analysis showed that the MACE(+)group had increased coronary artery disease history(40.0%vs.21.6%,P=0.006)and internal carotid artery tortuosity(67.5%%vs.37.6%,P<0.001).Furthermore,the MACE(+)group had higher systolic blood pressure(143.38±22.74 vs.135.42±17.17 mmHg,P=0.004).Multivariable analysis showed that the influencing factors for MACEs in CEA included history of diabetes(odds ratio[OR]=2.345;95%confidence interval[CI]=1.057-5.205;P=0.036)and MetS(OR=2.476;95%CI=1.065-5.757;P=0.035).The influencing factors for MACEs in CAS included systolic blood pressure(OR=1.023;95%CI=1.005-1.040;P=0.010),co

关 键 词：Metabolic syndrome Carotid endarterectomy Carotid artery stenting Major adverse clinical events Influencing factors 

分 类 号：R589[医药卫生—内分泌] R743[医药卫生—内科学]