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 Scopus citations

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 1 2010

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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