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

Xu, Yang; Luo, Wei; Han, Shan; Zha, Lei; Zhang, Jing; Li, Xiaowei; Zhao, Hui; Liang, Shuo; Zhao, Rui

doi:10.1186/s12872-020-01358-8

Cited by 9 publications

(7 citation statements)

References 35 publications

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“…Certainly, intracoronary imaging has demonstrated that plaques in MetS have a greater lipid burden compared with plaques in controls [ 31 ]. On CCTA, individuals with MetS are more likely than those without MetS to have non-calcified and high-risk plaques [ 32 , 33 ]. Beyond coronary atherosclerosis, MetS also associates with myocardial steatosis and subclinical myocardial dysfunction [ 34 ], which portend worse cardiac outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Metabolic syndrome, fatty liver, and artificial intelligence-based epicardial adipose tissue measures predict long-term risk of cardiac events: a prospective study

Lin

Wong

Razipour

et al. 2021

Cardiovasc Diabetol

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Background We sought to evaluate the association of metabolic syndrome (MetS) and computed tomography (CT)-derived cardiometabolic biomarkers (non-alcoholic fatty liver disease [NAFLD] and epicardial adipose tissue [EAT] measures) with long-term risk of major adverse cardiovascular events (MACE) in asymptomatic individuals. Methods This was a post-hoc analysis of the prospective EISNER (Early-Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research) study of participants who underwent baseline coronary artery calcium (CAC) scoring CT and 14-year follow-up for MACE (myocardial infarction, late revascularization, or cardiac death). EAT volume (cm3) and attenuation (Hounsfield units [HU]) were quantified from CT using fully automated deep learning software (< 30 s per case). NAFLD was defined as liver-to-spleen attenuation ratio < 1.0 and/or average liver attenuation < 40 HU. Results In the final population of 2068 participants (59% males, 56 ± 9 years), those with MetS (n = 280;13.5%) had a greater prevalence of NAFLD (26.0% vs. 9.9%), higher EAT volume (114.1 cm3 vs. 73.7 cm3), and lower EAT attenuation (−76.9 HU vs. −73.4 HU; all p < 0.001) compared to those without MetS. At 14 ± 3 years, MACE occurred in 223 (10.8%) participants. In multivariable Cox regression, MetS was associated with increased risk of MACE (HR 1.58 [95% CI 1.10–2.27], p = 0.01) independently of CAC score; however, not after adjustment for EAT measures (p = 0.27). In a separate Cox analysis, NAFLD predicted MACE (HR 1.78 [95% CI 1.21–2.61], p = 0.003) independently of MetS, CAC score, and EAT measures. Addition of EAT volume to current risk assessment tools resulted in significant net reclassification improvement for MACE (22% over ASCVD risk score; 17% over ASCVD risk score plus CAC score). Conclusions MetS, NAFLD, and artificial intelligence-based EAT measures predict long-term MACE risk in asymptomatic individuals. Imaging biomarkers of cardiometabolic disease have the potential for integration into routine reporting of CAC scoring CT to enhance cardiovascular risk stratification. Trial registration NCT00927693.

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Section: Discussionmentioning

confidence: 99%

“…On CCTA, individuals with MetS are more likely than those without MetS to have non-calcified and high-risk plaques [32,33]. Beyond coronary atherosclerosis, MetS also associates with myocardial steatosis and subclinical myocardial dysfunction [34], which portend worse cardiac outcomes.…”

Section: Mets and Coronary Atherosclerosismentioning

confidence: 99%

Metabolic syndrome, fatty liver, and artificial intelligence-based epicardial adipose tissue measures predict long-term risk of cardiac events: a prospective study

Lin

Wong

Razipour

et al. 2021

Cardiovasc Diabetol

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“…A VIF larger than 4.0 was considered an indication of severe multicollinearity in the regression model. 34 For the sensitivity analysis of the multivariable logistic regression, we also calculated a model with only including significant risk factors in the univariable analysis as covariates. All the statistical analyses were performed by IBM SPSS for Windows (V.20.0, SPSS, Chicago, IL, USA) and R software V.3.6.3.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and risk factors for hyperhomocysteinemia: a population-based cross-sectional study from Hunan, China

et al. 2021

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ObjectivesHyperhomocysteinemia is an independent risk factor for cardiovascular diseases. We aimed to investigate the prevalence and risk factors for hyperhomocysteinemia, especially modifiable lifestyle factors, such as smoking behaviour and dietary factors.DesignPopulation-based cross-sectional study.SettingHunan Province, ChinaParticipantsA total of 4012 participants completed the study, between July 2013 and March 2014. The median age is 55 (interquartile range: 45–63) years, with 1644 males (41%) and 2368 females (59%).Main outcome measuresHomocysteine level were measured by the microplate enzyme immunoassay method. Hyperthomocysteinemia was defined as ≥15 µmol/L. Questionnaire was used to investigate potential risk factors of hyperhomocysteinemia. Crude odd ratio (OR) or adjusted OR with 95% CI were determined by using univariable or multivariable logistic regression models.ResultsThe prevalence of hyperhomocysteinemia is 35.4% (45.4% vs 28.5% for men, women, respectively). One-year increase in age is significantly associated with 2% higher risk of hyperhomocysteinemia (OR=1.02, 95% CI: 1.01 to 1.03). One unit increase of BMI is associated with 5% higher risk of hyperhomocysteinemia (OR=1.05, 95% CI: 1.03 to 1.07). Compared with the non-smoker, smoking participants have a 24% higher risk of hyperhomocysteinemia (OR=1.24, 95% CI: 1.006 to 1.53), while the risk for those quitting smoking are not significantly different (OR=1.14, 95% CI: 0.85 to 1.54). compared with those consuming fruit and vegetable at least once every day, those consuming less than once every day had a significantly higher risk of hyperhomocysteinemia (OR=1.29, 95% CI:1.11 to 1.50). In addition, we found there were significant sex interaction with education level or alcohol drinking on the risk of hyperhomocysteinemia (pinteraction<0.05).ConclusionsHigher BMI and older age are potential risk factors for hyperhomocysteinemia. Current smoking but not quitting smoking is associated with higher risk of hyperhomocysteinemia. Fruit and vegetable consumption may have protective effect against hyperhomocysteinemia. Alcohol consumption or education level might interact to influence the risk of hyperhomocysteinemia.

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“…Raised hsCRP levels have been consistently associated with coronary heart disease and MetS. [43][44][45] In a study by Yang et al, 44 there was a higher level of hsCRP in the MetS group. This finding suggests a higher level of inflammation and oxidative stress in these patients, which creates a conducive pathophysiological environment for high-risk plaque development.…”

Section: Discussionmentioning

confidence: 99%

Effects of Metabolic Syndrome on Cardiovascular Outcomes of Psoriatic Patients with Coronary Artery Disease: A Single Center Retrospective Cohort Study

Zhao¹,

Sun²,

Yang³

et al. 2023

DMSO

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Background: Psoriasis is associated with an increased prevalence of cardiovascular risk factors, including metabolic syndrome (MetS). To date, it is unclear whether MetS causes differences in cardiovascular outcomes in psoriatic patients with coronary artery disease. Methods:We conducted a retrospective cohort study to determine the effects of MetS in psoriatic patients with coronary artery disease. Comparisons were made between patients with and without MetS. Cox regression analysis and Kaplan-Meier survival analysis were used to evaluate the association between variables. Results: Of the 307 psoriatic patients with coronary artery disease, 94 met criteria (30.6%) for MetS. Individuals with MetS were more likely to be female (p <0.001). Levels of platelet counts and high-sensitivity C-reactive protein were higher in the MetS group (p = 0.038 and 0.005, respectively). After a mean follow-up of 35.32 months, major adverse cardiovascular events (MACEs) and nonfatal myocardial infarction were more likely in the MetS than the non-MetS group (33.3% vs 20.6%, p = 0.02; 26.4% vs 15.7%, p = 0.032, respectively). Kaplan-Meier estimates showed the same trend. Cox regression analysis showed that MetS (hazard ratio 1.738; 95% confidence interval 1.045-2.891; p = 0.033) and left ventricular ejection fraction (hazard ratio 0.968; 95% confidence interval 0.945-0.991; p = 0.006) were associated with an increased risk of MACEs. Conclusion:In psoriatic patients with coronary artery disease, MetS independently predicted MACEs. In addition, left ventricular ejection fraction was negatively associated with an increased risk of MACEs. To reduce the cardiovascular disease risk, it is necessary to increase awareness of MetS in psoriatic patients with coronary artery disease.

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

Cited by 9 publications

References 35 publications

Metabolic syndrome, fatty liver, and artificial intelligence-based epicardial adipose tissue measures predict long-term risk of cardiac events: a prospective study

Metabolic syndrome, fatty liver, and artificial intelligence-based epicardial adipose tissue measures predict long-term risk of cardiac events: a prospective study

Prevalence and risk factors for hyperhomocysteinemia: a population-based cross-sectional study from Hunan, China

Effects of Metabolic Syndrome on Cardiovascular Outcomes of Psoriatic Patients with Coronary Artery Disease: A Single Center Retrospective Cohort Study

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