The metabolic syndrome is known to increase relative risk of diabetes and cardiovascular events. This study examined the metabolic syndrome’s impact on operative mortality after surgery in 5,304 consecutive patients who underwent a coronary artery bypass grafting (CABG) procedure. Of these patients, 46% met NCEP-ATP III clinical criteria for the metabolic syndrome. Operative mortality after the CABG surgery was 2.4% in patients with the metabolic syndrome compared to 0.9% in patients not meeting NCEP-ATP III clinical criteria (p<0.0001). After adjusting for covariates, operative mortality risk was significantly higher in patients with the metabolic syndrome and diabetes and in patients with the metabolic syndrome but without diabetes. However, the risk of operative mortality was not higher in the smaller group of diabetic patients without the features of the metabolic syndrome. Because metabolic syndrome components are modifiable risk factors, this study sought to determine whether it is possible to evaluate and manage the features of the metabolic syndrome in order to minimize operative mortality. It raises the issue of considering effective prevention strategies.
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