1. Is metabolic syndrome predictive of prevalence, extent, and risk of coronary artery disease beyond its components? Results from the multinational coronary CT angiography evaluation for clinical outcome: an international multicenter registry (CONFIRM).
- Author
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Ahmadi A, Leipsic J, Feuchtner G, Gransar H, Kalra D, Heo R, Achenbach S, Andreini D, Al-Mallah M, Berman DS, Budoff M, Cademartiri F, Callister TQ, Chang HJ, Chinnaiyan K, Chow B, Cury RC, Delago A, Gomez MJ, Hadamitzky M, Hausleiter J, Hindoyan N, Kaufmann PA, Kim YJ, Lin F, Maffei E, Pontone G, Raff GL, Shaw LJ, Villines TC, Dunning A, and Min JK
- Subjects
- Acute Coronary Syndrome complications, Acute Coronary Syndrome diagnostic imaging, Acute Coronary Syndrome mortality, Aged, Angioplasty, Cohort Studies, Coronary Angiography, Coronary Artery Disease complications, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease mortality, Female, Humans, International Cooperation, Male, Metabolic Syndrome complications, Metabolic Syndrome diagnostic imaging, Metabolic Syndrome mortality, Middle Aged, Myocardial Infarction complications, Myocardial Infarction diagnostic imaging, Myocardial Infarction mortality, Prevalence, Prognosis, Risk Assessment, Risk Factors, Severity of Illness Index, Survival Analysis, Tomography, X-Ray Computed, Acute Coronary Syndrome diagnosis, Coronary Artery Disease diagnosis, Metabolic Syndrome diagnosis, Myocardial Infarction diagnosis, Registries
- Abstract
Although metabolic syndrome is associated with increased risk of cardiovascular disease and events, its added prognostic value beyond its components remains unknown. This study compared the prevalence, severity of coronary artery disease (CAD), and prognosis of patients with metabolic syndrome to those with individual metabolic syndrome components. The study cohort consisted of 27125 consecutive individuals who underwent ≥ 64-detector row coronary CT angiography (CCTA) at 12 centers from 2003 to 2009. Metabolic syndrome was defined as per NCEP/ATP III criteria. Metabolic syndrome patients (n = 690) were matched 1:1:1 to those with 1 component (n = 690) and 2 components (n = 690) of metabolic syndrome for age, sex, smoking status, and family history of premature CAD using propensity scoring. Major adverse cardiac events (MACE) were defined by a composite of myocardial infarction (MI), acute coronary syndrome, mortality and late target vessel revascularization. Patients with 1 component of metabolic syndrome manifested lower rates of obstructive 1-, 2-, and 3-vessel/left main disease compared to metabolic syndrome patients (9.4% vs 13.8%, 2.6% vs 4.5%, and 1.0% vs 2.3%, respectively; p < 0.05), while those with 2 components did not (10.5% vs 13.8%, 2.8% vs 4.5% and 1.3% vs 2.3%, respectively; p > 0.05). At 2.5 years, metabolic syndrome patients experienced a higher rate of MACE compared to patients with 1 component (4.4% vs 1.6%; p = 0.002), while no difference observed compared to individuals with 2 components (4.4% vs 3.2% p = 0.25) of metabolic syndrome. In conclusion, Metabolic syndrome patients have significantly greater prevalence, severity, and prognosis of CAD compared to patients with 1 but not 2 components of metabolic syndrome.
- Published
- 2015
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