Metabolic syndrome is not associated with increased mortality or cardiovascular risk in nondiabetic patients with a new diagnosis of coronary artery disease

John L. Petersen, Eric Yow, Wael Aljaroudi, Linda K. Shaw, Abhinav Goyal, Darren K. McGuire, Eric D. Peterson, Robert A. Harrington

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background-Metabolic syndrome (MetSyn) is associated with increased cardiovascular risk in the general population. Its prognostic implications are less well defined in patients with coronary artery disease. Methods and Results-We analyzed patients in the Duke Database for Cardiovascular Disease with a diagnosis of incident obstructive coronary artery disease. Diabetes mellitus (DM) was classified as a clinical history of DM, use of hypoglycemic drugs, or fasting glucose of ≥126 mg/dL. MetSyn was defined as having 3 of 5 characteristics: fasting glucose ≥100 and <126 mg/dL, low high-density lipoprotein cholesterol (men, <40 mg/dL; women, >50 mg/dL), triglycerides >150 mg/dL, blood pressure ≥ 130/85 mm Hg, or use of antihypertensive therapy, or body mass index ≥27. Death, myocardial infarction, or stroke was assessed at 6 months, 1 year, then annually. Cox proportional hazards models were generated to compare mortality and cardiovascular events between groups. The primary cohort consisted of 5744 patients; 1831 (31.9%) had DM, 2491 (43.4%) had MetSyn, and 1422 (24.7%) had no DM/MetSyn. Median follow-up was 5 years. Compared with no DM/MetSyn patients, DM patients had a higher adjusted risk for mortality (hazard ratio, 1.47; 95% CI, 1.28 to 1.69) but MetSyn patients did not (hazard ratio, 0.94; 95% CI, 0.81 to 1.08). Similar results were found for the combined end points of death or myocardial infarction, and death, myocardial infarction, or stroke. Conclusions-In a population of consecutive patients with a new diagnosis of coronary artery disease by angiography, MetSyn without DM was not an independent predictor of mortality or cardiovascular events.

Original languageEnglish (US)
Pages (from-to)165-172
Number of pages8
JournalCirculation: Cardiovascular Quality and Outcomes
Volume3
Issue number2
DOIs
StatePublished - Mar 2010

Fingerprint

Coronary Artery Disease
Diabetes Mellitus
Mortality
Myocardial Infarction
Fasting
Stroke
Glucose
Proportional Hazards Models
Hypoglycemic Agents
Antihypertensive Agents
Population
Angiography
Triglycerides
Body Mass Index
Cardiovascular Diseases
Databases
Blood Pressure

Keywords

  • Coronary artery disease
  • Death
  • Diabetes mellitus
  • Metabolic syndrome
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Metabolic syndrome is not associated with increased mortality or cardiovascular risk in nondiabetic patients with a new diagnosis of coronary artery disease. / Petersen, John L.; Yow, Eric; Aljaroudi, Wael; Shaw, Linda K.; Goyal, Abhinav; McGuire, Darren K.; Peterson, Eric D.; Harrington, Robert A.

In: Circulation: Cardiovascular Quality and Outcomes, Vol. 3, No. 2, 03.2010, p. 165-172.

Research output: Contribution to journalArticle

Petersen, John L. ; Yow, Eric ; Aljaroudi, Wael ; Shaw, Linda K. ; Goyal, Abhinav ; McGuire, Darren K. ; Peterson, Eric D. ; Harrington, Robert A. / Metabolic syndrome is not associated with increased mortality or cardiovascular risk in nondiabetic patients with a new diagnosis of coronary artery disease. In: Circulation: Cardiovascular Quality and Outcomes. 2010 ; Vol. 3, No. 2. pp. 165-172.
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abstract = "Background-Metabolic syndrome (MetSyn) is associated with increased cardiovascular risk in the general population. Its prognostic implications are less well defined in patients with coronary artery disease. Methods and Results-We analyzed patients in the Duke Database for Cardiovascular Disease with a diagnosis of incident obstructive coronary artery disease. Diabetes mellitus (DM) was classified as a clinical history of DM, use of hypoglycemic drugs, or fasting glucose of ≥126 mg/dL. MetSyn was defined as having 3 of 5 characteristics: fasting glucose ≥100 and <126 mg/dL, low high-density lipoprotein cholesterol (men, <40 mg/dL; women, >50 mg/dL), triglycerides >150 mg/dL, blood pressure ≥ 130/85 mm Hg, or use of antihypertensive therapy, or body mass index ≥27. Death, myocardial infarction, or stroke was assessed at 6 months, 1 year, then annually. Cox proportional hazards models were generated to compare mortality and cardiovascular events between groups. The primary cohort consisted of 5744 patients; 1831 (31.9{\%}) had DM, 2491 (43.4{\%}) had MetSyn, and 1422 (24.7{\%}) had no DM/MetSyn. Median follow-up was 5 years. Compared with no DM/MetSyn patients, DM patients had a higher adjusted risk for mortality (hazard ratio, 1.47; 95{\%} CI, 1.28 to 1.69) but MetSyn patients did not (hazard ratio, 0.94; 95{\%} CI, 0.81 to 1.08). Similar results were found for the combined end points of death or myocardial infarction, and death, myocardial infarction, or stroke. Conclusions-In a population of consecutive patients with a new diagnosis of coronary artery disease by angiography, MetSyn without DM was not an independent predictor of mortality or cardiovascular events.",
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T1 - Metabolic syndrome is not associated with increased mortality or cardiovascular risk in nondiabetic patients with a new diagnosis of coronary artery disease

AU - Petersen, John L.

AU - Yow, Eric

AU - Aljaroudi, Wael

AU - Shaw, Linda K.

AU - Goyal, Abhinav

AU - McGuire, Darren K.

AU - Peterson, Eric D.

AU - Harrington, Robert A.

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N2 - Background-Metabolic syndrome (MetSyn) is associated with increased cardiovascular risk in the general population. Its prognostic implications are less well defined in patients with coronary artery disease. Methods and Results-We analyzed patients in the Duke Database for Cardiovascular Disease with a diagnosis of incident obstructive coronary artery disease. Diabetes mellitus (DM) was classified as a clinical history of DM, use of hypoglycemic drugs, or fasting glucose of ≥126 mg/dL. MetSyn was defined as having 3 of 5 characteristics: fasting glucose ≥100 and <126 mg/dL, low high-density lipoprotein cholesterol (men, <40 mg/dL; women, >50 mg/dL), triglycerides >150 mg/dL, blood pressure ≥ 130/85 mm Hg, or use of antihypertensive therapy, or body mass index ≥27. Death, myocardial infarction, or stroke was assessed at 6 months, 1 year, then annually. Cox proportional hazards models were generated to compare mortality and cardiovascular events between groups. The primary cohort consisted of 5744 patients; 1831 (31.9%) had DM, 2491 (43.4%) had MetSyn, and 1422 (24.7%) had no DM/MetSyn. Median follow-up was 5 years. Compared with no DM/MetSyn patients, DM patients had a higher adjusted risk for mortality (hazard ratio, 1.47; 95% CI, 1.28 to 1.69) but MetSyn patients did not (hazard ratio, 0.94; 95% CI, 0.81 to 1.08). Similar results were found for the combined end points of death or myocardial infarction, and death, myocardial infarction, or stroke. Conclusions-In a population of consecutive patients with a new diagnosis of coronary artery disease by angiography, MetSyn without DM was not an independent predictor of mortality or cardiovascular events.

AB - Background-Metabolic syndrome (MetSyn) is associated with increased cardiovascular risk in the general population. Its prognostic implications are less well defined in patients with coronary artery disease. Methods and Results-We analyzed patients in the Duke Database for Cardiovascular Disease with a diagnosis of incident obstructive coronary artery disease. Diabetes mellitus (DM) was classified as a clinical history of DM, use of hypoglycemic drugs, or fasting glucose of ≥126 mg/dL. MetSyn was defined as having 3 of 5 characteristics: fasting glucose ≥100 and <126 mg/dL, low high-density lipoprotein cholesterol (men, <40 mg/dL; women, >50 mg/dL), triglycerides >150 mg/dL, blood pressure ≥ 130/85 mm Hg, or use of antihypertensive therapy, or body mass index ≥27. Death, myocardial infarction, or stroke was assessed at 6 months, 1 year, then annually. Cox proportional hazards models were generated to compare mortality and cardiovascular events between groups. The primary cohort consisted of 5744 patients; 1831 (31.9%) had DM, 2491 (43.4%) had MetSyn, and 1422 (24.7%) had no DM/MetSyn. Median follow-up was 5 years. Compared with no DM/MetSyn patients, DM patients had a higher adjusted risk for mortality (hazard ratio, 1.47; 95% CI, 1.28 to 1.69) but MetSyn patients did not (hazard ratio, 0.94; 95% CI, 0.81 to 1.08). Similar results were found for the combined end points of death or myocardial infarction, and death, myocardial infarction, or stroke. Conclusions-In a population of consecutive patients with a new diagnosis of coronary artery disease by angiography, MetSyn without DM was not an independent predictor of mortality or cardiovascular events.

KW - Coronary artery disease

KW - Death

KW - Diabetes mellitus

KW - Metabolic syndrome

KW - Myocardial infarction

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