title: Impact of Metabolic Syndrome on Subclinical Atherosclerosis in Asymptomatic Individuals.
abstract: BACKGROUND
  Little is known about subclinical atherosclerosis on coronary computed tomographic angiography (CCTA) in asymptomatic individuals with metabolic syndrome (MetS).
  
  
  RESULTS
  We analyzed 5,213 asymptomatic individuals who underwent CCTA. A cardiac event was defined as a composite of all-cause death, myocardial infarction, unstable angina, or coronary revascularization. Of the study participants, 2,042 (39.2%) had MetS. MetS was an independent predictor of significant coronary artery disease (CAD) in at least 1 coronary artery (odds ratio [OR]=1.992, 95% confidence interval [CI]=1.623-2.445, P<0.001) and significant CAD in the left main (LM) or proximal left anterior descending (LAD) artery (OR=2.151, 95% CI=1.523-3.037, P<0.001). During the follow-up period (median 28.1 [interquartile range, 19.2-36.5] months), 111 individuals had 114 cardiac events. Individuals with MetS were significantly associated with more cardiac events than those without (RR [rate ratio]=1.67, 95% CI=1.15-2.43, P=0.007). In the MetS group, individuals with significant CAD had the majority of cardiac events (RR=64.33, 95% CI=29.17-141.88, P<0.001). Furthermore, in the MetS with significant CAD group, those with significant CAD in the LM or proximal LAD had more cardiac events (RR=2.63, 95% CI=1.51-4.59, P=0.001).
  
  
  CONCLUSIONS
  MetS was associated with subclinical atherosclerosis on CCTA with subsequent high risk for cardiac events. These findings suggest the importance of reducing unfavorable metabolic conditions in asymptomatic individuals.
authors.affiliation: Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
authors.forename: Gyung-Min
authors.initials: GM
authors.lastname: Park
authors.forename: Hyonggin
authors.initials: H
authors.lastname: An
authors.forename: Seung-Whan
authors.initials: SW
authors.lastname: Lee
authors.forename: Young-Rak
authors.initials: YR
authors.lastname: Cho
authors.forename: Eun Ha
authors.initials: EH
authors.lastname: Gil
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Her
authors.forename: Hyun Woo
authors.initials: HW
authors.lastname: Park
authors.forename: Jung-Min
authors.initials: JM
authors.lastname: Ahn
authors.forename: Duk-Woo
authors.initials: DW
authors.lastname: Park
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Kang
authors.forename: Young-Hak
authors.initials: YH
authors.lastname: Kim
authors.forename: Cheol Whan
authors.initials: CW
authors.lastname: Lee
authors.forename: Dong Hyun
authors.initials: DH
authors.lastname: Yang
authors.forename: Joon-Won
authors.initials: JW
authors.lastname: Kang
authors.forename: Tae-Hwan
authors.initials: TH
authors.lastname: Lim
authors.forename: Hong-Kyu
authors.initials: HK
authors.lastname: Kim
authors.forename: Jaewon
authors.initials: J
authors.lastname: Choe
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Park
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000789:Angina, Unstable / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality; D015996:Survival Rate; D014057:Tomography, X-Ray Computed