Prognostic Impact of the Metabolic Syndrome and Its Components in Acute Type A Aortic Dissection After Surgery: A 3-Year Follow-Up

Background The aim of this study is to explore whether or to what extent the metabolic syndrome (METs) and its components was associated with poor outcome in acute type A aortic dissection patients (ATAAD) after surgery. Methods This study involved 353 ATAAD patients undergo surgery. Data on demographic and clinical characteristics were collected. Subgroup analysis, mixed models regression analysis, score systems and receiver-operating characteristic curves (ROC) analysis were done. Results Overall, 353 inpatients were assigned to the poor outcome group (n = 69) and control group (n = 284) with or without METs. Compared to control group, the incidence of METs was higher in poor outcome group. Poor outcome were present in 0%, 4.4%, 12.3%, 47.6%, 71.4% and 100% of the six groups, who met the diagnostic criteria of MetS 0, 1, 2, 3, 4 and 5 times. For multivariable logistic regression, quartiles of BMI remained the risk factors of poor outcome after adjustment other risk factors. After adjustment for potential confounding factors, METs was an independent risk factors in several models. Assigning a score of one for each components, the AUC were 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. Conclusions METs, especially for BMI, confers greater risk for poor outcome in ATAAD after surgery during 3-year follow up.