Metabolic Syndrome (MS) and hs-CRP have been recommended for risk identification in coronary heart disease (CHD) prevention. However, it is not clear if information obtained by MS and hs-CRP is additive or redundant. We aimed to determine if MS and hs-CRP provide incremental information in coronary artery disease (CAD) risk.
Subjects scheduled for elective coronary angiography were prospectively evaluated for MS and hs-CRP. Exclusion criteria included older age (men > 55; women > 65), anti-lipid therapy, and prior CHD. MS was defined per NCEP III as the presence of ≥3 of the following traits: low HDL (men <40 mg/dL, women <50 mg/dL), high triglyceride (≥150 mg/dL), hypertension (≥130/85 mm Hg), fasting glucose (>/+110 mg/dL), and BMI ≥30. Elevated hs-CRP was defined as > 3mg/L. CAD was defined as stenosis ≥ 50%.
CAD was present in 77 (30%) of 253 subjects. Mean age was 51±8 (55% women). MS criteria was met by 75 subjects. Mean values for hs-CRP was similar among subjects with CAD compared to those without CAD (6.4±11.1 mg/L vs. 4.2±5.5 mg/L, p=NS), but significantly higher in subjects with MS compared to those without MS (6.4±9.5 mg/L vs. 3.7±5.4 mg/L, p=0.022). The odds associated with MS and CAD was 2.6 (CI:1.5-4.6, p=0.001). Among subjects without CAD, only 23% had MS, whereas 45% of individuals with CAD met criteria for MS. When MS and hs-CRP status were considered, we found that the coexistence of MS and elevated hs-CRP was associated with increased risk (OR:3.0, CI:1.5-6.1; p=0.003).
One-third of subjects evaluated for CAD met criteria for MS. Subjects with MS were more likely to have high-risk hs-CRP. MS is associated with coronary angiographic disease. The presence of high-risk hs-CRP in subjects with MS further increase CAD risk.
Identifying subjects with MS as per NCEP III guidelines may help identify individuals at risk for CAD, and high-risk hs-CRP values may help identify subjects with MS at particularly high risk for CAD.
K.O. Akosah, None.