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272 IS METABOLIC SYNDROME AN INDEPENDENT RISK FACTOR FOR CORONARY ARTERY DISEASE?
  1. A. J. Weissman1,
  2. S. Brown1,
  3. D. Hersh1,
  4. M. Rybstein1,
  5. G. Panagopoulos1,
  6. N. L. Coplan1
  1. 1Lenox Hill Hospital, New York, NY

Abstract

Introduction Metabolic syndrome consists of a constellation of metabolic abnormalities that include glucose intolerance, obesity, elevated blood pressure, and dyslipidemia. There are conflicting results in the medical literature as to whether the components of the metabolic syndrome, taken together or individually, can improve existing methods for estimating the risk for CV disease. The purpose of this study was to determine if the metabolic syndrome is an independent risk factor for the presence of CAD.

Methods The study included 469 patients with no known history of CAD who presented for elective cardiac catheterization. These patients were evaluated for the presence (M+) or absence (M−) of the metabolic syndrome using the NCEP-ATP III criteria; CAD was defined as the presence of ≥ 70% stenosis in one of the three major coronary vessels or 50% stenosis in the left main coronary artery. The relationship between the metabolic syndrome and the presence of CAD was assessed by using the Pearson chi-square test.

Results Metabolic syndrome was present in 233/469 patients (49.7%), and M+ was significantly more likely to have CAD than M− (44.2 vs 33.1%, p = .013). There was no significant difference between M+/M− with regard to the mean Framingham risk score or for age, tobacco use, or family history of CAD; there was a significantly increased prevalence of DM (FBS ≥ 126 or DM Rx) in the M+ group (p < .001). Given that DM is a coronary risk equivalent, subgroups with DM and without DM were evaluated separately:

DM+/M+ was also found to have significantly more severe CAD (LM or 3VD) than DM+/M− (21% vs 4%, p = .04). This relationship was not seen in the DM− group.

Conclusion Metabolic syndrome is a risk factor for obstructive coronary artery disease and more extensive CAD in diabetics but not in nondiabetics.

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