The effects of metabolic syndrome versus infectious burden on inflammation, severity of coronary atherosclerosis, and major adverse cardiovascular events.
BACKGROUND
The clinical predictors of inflammation in atherosclerosis remain controversial. The objective of this study was to compare the associations of metabolic factors vs. infectious burden (IB) with inflammation, the severity of coronary atherosclerosis, and major adverse cardiovascular events (MACEs).


METHODS
Coronary angiography with Gensini score was applied to assess the severity of coronary atherosclerosis in 568 patients with coronary artery disease. Metabolic syndrome (MS) score (0-5) was defined according to the modified criteria of National Cholesterol Education Program Adult Treatment Panel III. IB score (0-7) was defined as the number of seropositivities to several agents.


RESULTS
IB score was not associated with plasma C-reactive protein (CRP) concentration, Gensini score, or the risk of MACE. In contrast, MS score significantly correlated with both plasma CRP concentration and Gensini score (P < 0.001 for both). MS score and plasma CRP concentration were also significantly associated with the risk of MACE (hazard ratios 1.51, P < 0.001; and 1.90, P = 0.002, respectively).


CONCLUSIONS
Compared with IB, metabolic abnormalities have a more prominent association with the degree of inflammation, the severity of coronary atherosclerosis, and the risk of MACE in patients with coronary artery disease.
Dai
Dao-Fu
DF
Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan.
Lin
Jou-Wei
JW
Kao
Jia-Horng
JH
Hsu
Chih-Neng
CN
Chiang
Fu-Tien
FT
Lin
Jiunn-Lee
JL
Chou
Yi-Hua
YH
Hsu
Kwan-Lih
KL
Tseng
Chuen-Den
CD
Tseng
Yung-Zu
YZ
Hwang
Juey-Jen
JJ
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000276:immunology*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000453:epidemiology* / Q000276:immunology*; D007249:Inflammation / Q000453:epidemiology / Q000276:immunology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000276:immunology*; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012720:Severity of Illness Index
D002097:C-Reactive Protein