Metabolic Syndrome Increases Risk of Postoperative Myocardial Infarction Following Percutaneous Nephrolithotomy. Journal Article

Local Library Link: Find It @ Loyola

Authors: Johans, C; Bajic, P; Kirshenbaum, E; Blackwell, RH; Kothari, AN; Kuo, P; Baldea, K; Turk, T
Article Title: Metabolic Syndrome Increases Risk of Postoperative Myocardial Infarction Following Percutaneous Nephrolithotomy.
Abstract: INTRODUCTION: Percutaneous nephrolithotomy (PCNL) is the gold standard treatment for upper tract stone burdens greater than 2cm. Metabolic syndrome (MetS) is a constellation of conditions (diabetes mellitus, hypertension, dyslipidemia, and obesity) and is a risk factor for nephrolithiasis. Our objective was to investigate adverse cardiovascular outcomes of PCNL in patients with comorbid MetS diagnoses. METHODS: Data from the Healthcare Cost and Utilization Project State Inpatient Database for Florida and California were used to identify PCNL patients (ICD9: 55.03, 55.04) between 2007 and 2011. Patients were categorized having zero, 1-2, or 3-4 components of MetS. Postoperative myocardial infarction (MI) and in-hospital mortality outcomes were identified. Multivariate logistic regression was used to control for patient characteristics (age race, primary insurance provider) and medical comorbidities. RESULTS: PCNL was performed on 39,868 patients, of whom 17,932 (45.0%) had no MetS conditions, 19,268 (48.3%) had 1-2 MetS conditions, and 2,668 (6.7%) had 3-4 MetS conditions. With increasing MetS conditions, patients had increased incidence of postoperative MI (zero: 0.6%; 1-2: 1.0%; 3-4: 1.8%, p0.001). On multivariate analysis, the presence of 3-4 MetS comorbidities increased the odds of a postoperative MI (1-2: OR 1.2, 95% CI 0.94-1.53, p=0.147; 3-4: OR 2.2, 95%CI 1.54-3.15, p0.001). CONCLUSION: MetS patients have an increased risk of MI following PCNL given their preexisting comorbidities. Routine preoperative cardiac testing may benefit this population prior PCNL.
Journal Title: Journal of Endourology
Publisher: Unknown  
Date Published: 2018