PURPOSE: Metabolic Syndrome has major public health implications for diabetes and coronary heart disease prevention. However, the role of Metabolic Syndrome on cardiovascular disease and future cardiovascular events have not been well studied.
METHODS: 253 individuals (men ≥ 55, women ≥ 65) scheduled for elective coronary angiography were prospectively studied. Subjects had clinical risk scores calculated and fasting blood drawn on the day of angiography. Severe coronary artery disease was defined as stenosis ≥ 50%. Future cardiovascular events were defined as death, myocardial infarction (MI), and stroke.
RESULTS: 140 women and 113 men (mean age 51 ± 8) were enrolled. For the cohort, mean total, LDL, and HDL cholesterol, and triglycerides were 207 ± 42 mg/dL, 125 ± 36 mg/dL, 50 ± 15 mg/dL, and 171 ± 121 mg/dL, respectively. Framingham risk scores categorized 178 subjects as low-risk (70%), 18 subjects as intermediate-risk (7%), and 47 subjects (19%) as CHD equivalent (high-risk plus CHD equivalent). Severe coronary artery disease was diagnosed in 77 subjects. Subjects were catergorized into three groups: group 1 = metabolic syndrome (n=75), group 2 = CHD equivalent without concomitant metabolic syndrome (n=23), group 3 = low-risk without metabolic syndrome (n=140). Coronary artery disease was diagnosed in 45% in group 1 and 43% in group 2 compared to 18% in group 3 (p=0.001). After median follow-up of 32 months, 10 subjects suffered 12 events (death=3, MI=5, stroke=4). Subjects with metabolic syndrome developed more cardiovascular events compared to subjects without metabolic syndrome (group 1 = 8% and group 2 = 4.5% versus group 3 = 1.4% [p=0.035]).
CONCLUSION: Metabolic syndorme confers risk for coronary heart disease similar to that of CHD equivalent. Metabolic syndrome was associated with significantly higher rates of adverse outcomes compared to subjects without metabolic syndrome.
CLINICAL IMPLICATIONS: These results suggest that metabolic syndrome may be an important risk for the development of coronary artery disease and future complication.
DISCLOSURE: Amit Kulkarni, None.