Differential Relationship between Metabolic Syndrome Score and Severity of Coronary Atherosclerosis as Assessed by Angiography in a Non-Diabetic and Diabetic Korean Population

Abstract

Whether the metabolic syndrome (MetS) has prognostic value for coronary artery disease (CAD) beyond its individual components is controversial. We compared the relationship between the number of MetS components and CAD severity as assessed by angiography in non-diabetic and diabetic subjects. We consecutively enrolled 527 patients who underwent their first coronary angiography. Patients were divided into four groups according to the number of MetS components: 0/1, 2, 3, and 4/5. A coronary atherosclerosis score was used to quantify the extent of atherosclerotic involvement. The relationship between the MetS score and angiographic CAD severity or clinical presentation was compared between non-diabetic and diabetic subjects. Individuals with the MetS (n = 327) had a higher prevalence of CAD (60% vs 32%, P < 0.001), multi-vessel disease (34% vs 16%, P < 0.001), and acute coronary syndromes (49% vs 26%, P < 0.001) than those without the MetS. In the non-diabetic group, atherosclerosis score increased with the MetS score (1.0 ± 2.1, 2.0 ± 2.9, 2.8 ± 2.9, and 3.6 ± 3.9, P < 0.001) whereas there was no significant difference in the diabetic group (0.5 ± 1.0, 5.2 ± 4.7, 4.2 ± 2.9, and 4.4 ± 3.5, P = 0.102). The MetS score is related to CAD severity in non-diabetic patients but the association between the MetS score and angiographic CAD severity may be obscured in the presence of diabetes.

Is metabolic syndrome related with coronary artery disease severity and complexity: An observational study about IDF and AHA/NHLBI metabolic syndrome definitions

“…Patients with MS are at increased risk of cardiovascular events (2-fold increase in cardiovascular outcomes, cardiovascular mortality, myocardial infarction and stroke, and a 1.5-fold increase in all-cause mortality) [3,4]. However, there is still a controversy about the association of MS with stable coronary artery disease (CAD) [5][6][7][8][9][10].…”

Usefulness of Glycated Hemoglobin as Diagnostic Criteria for Metabolic Syndrome

“…It was reported that number of MetS component was related to the severity of coronary atherosclerosis especially in non-diabetic patients (4). The underlying pathophysiology of MetS is insulin resistance, but direct measurement of insulin sensitivity is complex and not readily available.…”

Coronary artery disease in a rural population of Bangladesh: is dyslipidemia or adiposity a significant risk?

“…But, logistic regression analysis disproved its effect on CAD. MetS though associated with CAD, it has not been found consistent [17,18]. Smoking was found significant (Table-2: p=0.02) in bivariate analysis, but ultimately was found insignificant.…”