INTRODUCTION
Metabolic syndrome (MetS) is a complex condition defined by the presence
of specific risk factors such as high systemic blood pressure,
atherogenic dyslipidaemia, high fasting glucose concentration, and
obesity(1-3). It has a high prevalence worldwide and is very prominent
in countries with Western life-style, affecting around 34–39% of the
adult population(4).
MetS is known to be associated to a pro-inflammatory and prothrombotic
state, due to adipose tissue dysfunction and insulin resistance, with
potentially harmful secretion concentration of cytokines and ultimately
endothelial dysfunction(5).
Some studies have evaluated the effect of MetS on the prognosis of
patients with coronary artery disease undergoing coronary artery bypass
grafting (CABG)(6, 7). In a Canadian large retrospective analysis, the
presence of MetS tripled the risk of in-hospital mortality after
CABG(8). It appeared also, according to other studies, that patients
with MetS were more prone to develop post-operative renal failure(8), or
to have higher incidence of wound dehiscence(6, 8), post-operative
stroke(9) and cognitive dysfunction(10).
MetS was also found to be responsible for prolonged postoperative
hospital and intensive care unit stays (ICU) with women having higher
stays and rates of in‐hospital death (11).
The effect of MetS on post-operative complications after isolated valve
intervention is poorly investigated. We hypothesized that MetS may be a
detrimental condition for patients undergoing valve intervention.
Thus, the main study aim was to determine whether patients with MetS
(defined according to the World Health Organization (WHO) criteria)
requiring isolated valvular intervention (defined as isolated surgical
aortic valve replacement (SAVR) or percutaneous aortic valve replacement
(TAVR) or mitral valve surgery (repair/replacement with or without
tricuspid valve repair (MVS)) were exposed to increase post-operative
in-hospital mortality and prolonged post-operative length of stay (LOS).
Predictors for in-hospital mortality and post-operative LOS were also
examined. In-hospital survival probability and in between centres
variability was investigated.