Prevalence of metabolic syndrome in heart transplant patients: role of previous cardiopathy and years since the procedure—the TRACA study

Alberto Cordero Fort, Juan José Gavira, Eduardo Alegría-Barrero, Sara Castaño, Ana Martín, Matías Ubilla, Stefano Mastrobuoni, Eduardo Alegría Ezquerra, Jesús Herreros, Gregorio Rábago
Journal of Heart and Lung Transplantation 2006, 25 (10): 1192-8

BACKGROUND: Metabolic syndrome (MS) is a cluster of cardiovascular risk factors highly prevalent in patients with ischemic heart disease (IHD), the main etiologic cause for heart transplantation (HT).

METHODS: Data for 111 HT patients of a single institution were collected. The assessment of MS was made, according to the ATP III criteria, when 3 of the following diagnostic criteria were present: waist circumference >102 cm (men) or >88 cm (women); triglycerides > or =150 mg/dl; HDL-cholesterol <40 mg/dl (men) or <50 mg/dl (women); blood pressure > or =130/85 mm Hg; and fasting glucose > or =110 mg/dl, or diabetes mellitus previously diagnosed. Renal function was assessed by glomerular filtration rate, as estimated by the MDRD abbreviated equation.

RESULTS: Mean age of the 111 HT patients was 63.0 (11.0) years and 101 (91.0%) were men. The median time since transplant was 7.0 (3.0 to 13.0) years, and IHD was the primary cause for HT (56.8%). The prevalence of MS was 42.3% and was statistically higher in patients with IHD prior to HT (52.4% vs 27.2%; p = 0.007). Patients with MS were older but had the same time of follow-up since their HT. An analysis of the sample in tertiles of years since HT showed that MS was more prevalent in subjects who received HT due to IHD only in the lowest and highest tertile. Fifty-three patients (47.7%) had abdominal obesity, 47 (43.2%) were overweight and 22 (19.8%) were obese; most patients with abdominal obesity were diagnosed with MS (82.6%). Multivariate analysis showed a strong association between abdominal obesity and MS (odds ratio [OR] 6.2, 95% confidence interval [CI] 1.9 to 19.8), even after adjustment for body mass index, and also showed an independent association of MS with severe renal dysfunction (OR 9.8; p = 0.02).

CONCLUSIONS: MS is highly prevalent in HT patients and abdominal obesity is the leading cause of this clustering. IHD status and time since HT are major determinants in the prevalence of MS in HT patients.

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