Impact of metabolic syndrome on the progression of coronary calcium and of coronary artery disease assessed by repeated cardiac computed tomography scans

Abstract

BackgroundIt is not clear how severe metabolic syndrome (MS) affects the development of coronary atherosclerosis.MethodsThis was an observational, retrospective cohort study with Koreans who received health check-ups voluntarily. A total of 2426 subjects had baseline and follow-up coronary artery calcium score (CACS) data. Among them, 1079 had coronary computed tomography angiography (CCTA) data. We compared baseline CACS and any progression in subjects with and without MS. A more detailed analysis was conducted for coronary artery disease (CAD), which was defined by coronary artery stenosis (≥50 %), multivessel involvement, and coronary plaques in those patients with CCTA data.ResultsAt baseline, subjects with MS (34.0 %, n = 825) had higher CACS and more significant coronary artery stenosis, multivessel involvement, and atheromatous plaques than those without MS (P < 0.05 for all). In the follow-up (median 1197 days), subjects with MS showed significant increases in CACS and progression of CAD compared with counterparts without MS, in parallel with the numbers of MS components. Finally, MS was a significant predictor for the progression of CACS (hazard ratio 1.32; 95 % confidence interval 1.06–1.64) and progression of coronary artery stenosis and/or development of vulnerable plaque (hazard ratio 1.47, 95 % confidence interval 1.01–2.15) after adjusting for other cardiovascular risk factors.ConclusionsSubjects with MS showed progression of CAD as assessed by CACS and CCTA over ~3 years. Therefore, more vigilant screening for coronary vascular health is needed among those with MS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-016-0404-7) contains supplementary material, which is available to authorized users.

Obesity, metabolic syndrome and cardiovascular prognosis: from the Partners coronary computed tomography angiography registry

“…However, 5 cross-sectional studies suggested a slight increase in subclinical atherosclerosis among those with MHO, which suggests that with a longer follow-up and larger sample size a small increased risk might be identified even for metabolically healthy obesity. A study looking at progression of plaque with coronary CTA reported that MetS was an independent predictor of progression of coronary artery stenosis or development of vulnerable plaque after accounting for traditional CM risk factors including BMI, HR = 1.47, (95% CI 1.01–2.15, p = 0.045) [38]. …”

Prevalence of high-risk coronary plaques in patients with and without metabolic syndrome and the relationship with prognosis

“…During follow-up the proportion of MACEs in patients with metabolic syndrome was significantly increased, and multiple regression analysis still indicated that metabolic syndrome was a risk factor for MACEs after adjustment for the relevant risk factors. This indicates that the calcification score of patients with metabolic syndrome progresses rapidly and is an independent risk factor for the progression of high-risk vulnerable coronary plaques [31]. Metabolic syndrome also increases the risk of coronary atherosclerosis in postmenopausal women through arterial stiffness [32].…”

Detection and quantification of coronary calcium from dual energy chest x‐rays: Phantom feasibility study

“…To analyze the effect of beam hardening on the coronary artery calcium (CAC) signal, we varied the adipose layer thickness in the stylized phantom with AEC exposures and calculated the CAC contrast, DI CAC , in the DECC image as given in Eq. (14).…”

“…(Defined ASCVD events do not include peripheral artery disease, heart failure, revascularization, and other atherosclerosis‐related, life‐altering events.) Calcium score can play a particular role for high risk groups having diabetes, rheumatoid arthritis, HIV, etc . Despite great enthusiasm among many physicians for CT coronary calcium score, there is little support for population screening due to its costs (both patient charges and radiation).…”

“…Calcium score can play a particular role for high risk groups having diabetes, rheumatoid arthritis, HIV, etc. 10,[14][15][16][17][18][19][20][21][22] Despite great enthusiasm among many physicians for CT coronary calcium score, there is little support for population screening due to its costs (both patient charges and radiation).…”