Metabolic Syndrome and Its Components are Associated with In-Hospital Complications after Thoracic Endovascular Aortic Repair for Acute Type B Aortic Dissection

Ann Vasc Surg. 2023 Jul:93:188-199. doi: 10.1016/j.avsg.2023.01.012. Epub 2023 Jan 13.

Abstract

Background: This study aimed to explore whether and to what extent metabolic syndrome (MetS) and its components are associated with in-hospital complications in patients with acute type B aortic dissection after thoracic endovascular aortic repair (TEVAR).

Methods: We retrospectively enrolled 684 patients who had undergone TEVAR. Demographic and clinical data were collected and subgroup analysis, mixed-model regression analysis, scoring systems, and receiver operating characteristic (ROC) curve analyses were performed.

Results: Overall, 684 inpatients were assigned to the poor outcome (n = 90) or no complications (n = 594) group. Compared to the no complications group, the poor outcome group had a higher incidence of MetS (44 [48.9%] vs. 120 [20.2%], P < 0.05). In the subgroup analysis, in-hospital complications were present in 3.1%, 6.6%, 11.9%, 20.7%, 40.0%, and 62.5% of patients in the 6 groups who met the 0, 1, 2, 3, 4, and 5 MetS diagnostic criteria, respectively. On multivariable logistic regression, hypertension (odds ratio [OR]: 2.680; 95% confidence interval [CI]: 1.571-4.570), type 2 diabetes (OR: 2.135; 95% CI: 1.192-3.824), quartiles of body mass index (OR: 1.801; 95% CI: 1.415-2.291), high-density lipoprotein cholesterol (OR: 0.763; 95% CI: 0.611-0.953), and systolic blood pressure (OR: 1.894; 95% CI: 1.486-2.413) were independent factors for in-hospital complications after adjustment for other risk factors. After adjusting for potential confounding factors, MetS was an independent risk factor for in-hospital complications. We established a scoring system for each component and the area under the ROC curve was 0.664 (95% CI: 0.618-0.710) in all patients, 0.672 (95% CI: 0.595-0.749) in patients with MetS, and 0.610 (95% CI: 0.552-0.667) in patients without MetS, as determined by ROC analysis.

Conclusions: MetS, especially the blood pressure component, confers a greater risk of in-hospital complications in patients with acute type B aortic dissection after TEVAR.

MeSH terms

  • Aortic Aneurysm, Thoracic* / diagnostic imaging
  • Aortic Aneurysm, Thoracic* / etiology
  • Aortic Aneurysm, Thoracic* / surgery
  • Aortic Dissection* / diagnostic imaging
  • Aortic Dissection* / surgery
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Diabetes Mellitus, Type 2*
  • Endovascular Aneurysm Repair
  • Endovascular Procedures* / adverse effects
  • Hospitals
  • Humans
  • Metabolic Syndrome* / complications
  • Metabolic Syndrome* / diagnosis
  • Metabolic Syndrome* / epidemiology
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome