[Metabolic syndrome may be better at predicting the prognosis of coronary artery disease than other traditional cardiovascular risk factors].
OBJECTIVE
The prevalence of cardiovascular risk factors is growing. People with metabolic syndrome (MS) plus five cardiovascular risk factors are at a higher risk of developing coronary artery disease (CAD). The effect of metabolic syndrome on outcomes in patients with preexisting CAD has not been well studied. The present study was conducted to assess the prevalence, characteristics and long-term prognosis of CAD with metabolic syndrome and to determine which factor is the most influential prognostic factor of CAD.


METHODS
The DESIRE (drug-eluting stent impact on revascularization) registry represented a database of 2368 CAD patients between July 2003 and September 2004. The median long-term follow-up was 3.5 years (293 -1855 days). Metabolic syndrome was based on the modified version of Adult Treatment Panel (ATP) III Definition of Metabolic Syndrome in 2005 using body mass index (BMI) instead of waist circumference. We tested the utility of MS and its components to predict the incidence of major adverse cardiac and cerebral events (MACCE) in a large cohort of patients undergoing revascularization.


RESULTS
The presence of MACCE was predicted only by MS (OR = 1.319, 95% CI 1.020 - 1.706, P = 0.035) but not other cardiovascular risk factors, such as advance age, male, smoking, high LDL cholesterol and CAD family history. MS was present in 45.6% (high fasting glucose 44.5%; high triglyceride 45.0%; low HDL 50.8%; high blood pressure 61.4%; high BMI 60.7%).


CONCLUSIONS
Among the traditional cardiovascular risk factors, only metabolic syndrome has a primary predictive ability for MACCE in CAD patients.
Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences, 100029, China.
Rong
R
Hu
Chang-Sheng
CS
Ma
Shao-Ping
SP
Nie
Qiang
Q
Lü
Jun-Ping
JP
Kang
Xin
X
Du
Xiao-Hui
XH
Liu
Fang
F
Chen
Yue-Jie
YJ
Zhou
Shu-Zheng
SZ
Lü
D000368:Aged; D008078:Cholesterol, LDL / Q000032:analysis; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D014280:Triglycerides / Q000032:analysis
D008078:Cholesterol, LDL; D014280:Triglycerides