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.