Diabetes exacerbates angiographic coronary lesion progression in subjects with metabolic syndrome independent of CRP levels.
BACKGROUND
Metabolic syndrome is gaining more attention as a special cluster of cardiovascular risks. However, its role, with or without diabetes, in predicting atherosclerosis progression, remains largely undetermined. We investigated the predictors for angiographic coronary atherosclerosis progression in patients with metabolic syndrome and angina pectoris.


METHODS
Patients with metabolic syndrome and angina pectoris who underwent repeat coronary angiograms and had serum samples at the time of first catheterization were enrolled for analysis (N=113). A modified Gensini scoring system was used to define CAD progression between the index and follow-up angiograms. Those who had significant angiographic progression of coronary disease were classified as the progression group (N=42) and those who did not as the non-progression group (N=71).


RESULTS
There were more cases of diabetes mellitus (52% vs. 31%, p=0.040) in the CAD progression group. The progression group also had higher baseline fasting blood glucose (150+/-73 vs. 117+/-46 mg/dl, p=0.010) but similar LDL cholesterol (114+/-38 vs. 109+/-33 mg/dl, p=0.421) than the non-progression group. In terms of inflammatory markers, there was no difference in hs-CRP (p=0.208), MCP-1 (p=0.514), or sCD40L (p=0.549) between the groups. In binary logistic regression, diabetes mellitus remained a significant predictor of CAD progression (OR 2.43, p=0.030) for patients with metabolic syndrome and angina pectoris, but hs-CRP and LDL-C were not.


CONCLUSIONS
Diabetes mellitus, but not inflammatory marker hs-CRP or LDL-C, is a significant predictor of angiographic CAD progression in patients with metabolic syndrome and angina pectoris.
Liang
Kae-Woei
KW
Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan.
Lee
Wen-Jane
WJ
Lee
Wen-Lieng
WL
Chen
Ying-Tsung
YT
Ting
Chih-Tai
CT
Sheu
Wayne Huey-Herng
WH
D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000150:complications* / Q000473:pathology; D000792:Angiography; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications* / Q000473:pathology*; D048909:Diabetes Complications / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000473:pathology
D015415:Biomarkers; D002097:C-Reactive Protein