Metabolic syndrome is a multifaceted risk factor for cardiovascular disease. It has been given an increase in importance by the foremost authority on the subject, National Cholesterol Education Program, Adult Treatment Panel III (NCEP ATP III). There has been no study, to date, looking at the components of the fasting atherosclerosis treatment study panel and their association with metabolic syndrome relative to non-metabolic syndrome patients in a clinical cardiac population. We investigated 165 cardiac patients (age 63.4 ± 13 years), 102 males (47 with metabolic syndrome), and 63 females (24 with metabolic syndrome). Our study showed that patients with metabolic syndrome have, on average, significantly lower levels of HDL-2 subfraction (p ≤ 0.0001), LDL particle size (p ≤ 0.0001), and a significant increase in VLDL (p ≤ 0.0001), C-reactive protein (p ≤ 0.0001), APO CIII (p ≤ 0.0001) and homocysteine (p ≤ 0.05) in relation to the non-metabolic syndrome cardiac patients. Other interesting findings include the HDL-2 subfraction is reduced in the majority of metabolic syndrome and non-metabolic syndrome cardiac patients. Only 5% of our sample population fell within the normal range for HDL-2, using the male reference range of 14-200 mg/dl, and a female reference range of 17-200 mg/dl. Homocysteine is elevated in the majority of the metabolic syndrome and non-metabolic syndrome patients. Only 10% of our sample population fell within normal range, between 0 - 9 μmol/L. Our findings suggest that these specific blood components may possibly have clinical contributions, in addition to the current NCEP ATP III guidelines, in the diagnosis and potential treatment targets for patients with metabolic syndrome and the prevention of cardiovascular disease.