Prevalence and clinical features of metabolic syndrome in recipients after orthotopic heart transplantation

Abstract

The aim – to determine the prevalence of metabolic syndrome (MS) in recipients after orthotopic heart transplantation (OHT) and to assess its clinical features.
Materials and methods. A retrospective analysis was conducted on 112 recipients who underwent orthotopic heart transplantation between 2019 and 2024 at the Heart Institute of the Ministry of Health of Ukraine. Patients were divided into two groups: Group A (n = 41) – with MS before transplantation, and Group B (n = 71) – without MS. Anthropometric, biochemical parameters, echocardiographic data, and survival rates were evaluated. The diagnosis of MS was established according to the NCEP-ATP III criteria.
Results. The proportion of males in Group A was higher (95.1 % vs. 78.9 %, p = 0.021). The mean age in Group A was 53 (46; 56) years, which was higher than in Group B (40 (32; 53), p = 0.003). MS was associated with a higher body mass index (p = 0.001), a greater prevalence of ischemic cardiomyopathy (41.5 % vs. 19.7 %, p = 0.043), and elevated creatinine levels (p = 0.016). One year after transplantation, the prevalence of MS increased to 50.5 % (p = 0.041), primarily due to elevated triglyceride levels (> 1.7 mmol/L, p = 0.014), increased blood pressure (≥ 130/85 mm Hg, p = 0.0001), and а rise in the proportion of recipients with diabetes mellitus or fasting glucose ≥ 5,6 mmol/L (p = 0.012). Kaplan – Meier survival analysis demonstrated that recipients with MS before OHT had significantly lower one-year survival compared to those without MS [(82.9 ± 5.9) % vs. (94.4 ± 2.7) %, p = 0.048].
Conclusions. MS is common among recipients after OHT and may worsen prognosis by increasing cardiovascular risk. The obtained results indicate the need for careful monitoring and correction of metabolic disorders in this patient population.