Prognostic impact of the metabolic syndrome and its components in acute type a aortic dissection after surgery: a retrospective study.

Abstract

Objective: This study aimed to explore whether metabolic syndrome (MetS) and its components are associated with poor outcomes in patients with acute type A aortic dissection (ATAAD) after surgery.

Methods: This study included 353 patients who had undergone surgery. Demographic and clinical characteristics of the patients were collected. Subgroup, mixed-model regression, score systems, and receiver operating characteristic curve (ROC) analyses were performed.

Results: Overall, 353 inpatients were assigned to the poor outcome group (n = 69) and control group (n = 284) with or without MetS. Compared to the control group, the incidence of MetS was higher in the poor outcome group. Poor outcomes were present in 0%, 4.4%, 12.3%, 47.6%, 71.4%, and 100% of the six groups who met the diagnostic criteria for MetS 0, 1, 2, 3, 4, and 5 times, respectively. For multivariable logistic regression, Body mass index (BMI) quartiles remained risk factors for poor outcomes after adjustment for other risk factors. After adjusting for potential confounding factors, the MetS was found to be an independent risk factor in several models. Assigning a score of one for each component, the AUC was 0.877 (95%CI: 0.823-0.923) in all patients, 0.864 (95%CI: 0.7945-0.935) in MetS, and 0.700 (95%CI: 0.567-0.833) in non-MetS by receiver operating characteristic.

Conclusion: MetS, especially BMI, confer a greater risk of poor outcomes in ATAAD after surgery during the 3-year follow-up.