Prevalence and Prognostic Impact of Subclinical Cardiovascular Disease in Individuals With the Metabolic Syndrome and Diabetes
Key result
Metabolic syndrome with subclinical cardiovascular disease was associated with an increased risk of overt cardiovascular disease compared to the absence of these conditions (HR 2.67; 95% CI 1.62-4.41).
Why the study?
Does the presence of subclinical cardiovascular disease modify the risk of overt cardiovascular disease in individuals with metabolic syndrome or diabetes?
Population
1,945 Framingham Offspring Study participants, mean age 58 years, 59% women.
Comparison
Presence of metabolic syndrome and/or diabetes… vs Absence of metabolic syndrome, diabetes, and…
Design
Cohort
Follow-up
mean 7.2 years
Authors
Discussion
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Implication
Subclinical CVD may refine MetS risk stratification in middle-aged adults; leaves open whether screening improves outcomes.
Key Points
- This study aims to determine the prevalence of subclinical cardiovascular disease in individuals with metabolic syndrome and diabetes and its prognostic impact on cardiovascular risk.
- Analyzed data from 1,945 Framingham Offspring Study participants, mean age 58 years; 51% assessed positive for subclinical disease using various tests.
- Evaluated the incidence of overt cardiovascular disease over a mean follow-up of 7.2 years, focusing on participants with versus without metabolic syndrome and diabetes.
- Calculated multivariable-adjusted odds ratios and hazards ratios for the risk of overt cardiovascular disease associated with metabolic syndrome and subclinical disease.
- 51% of participants with metabolic syndrome had subclinical cardiovascular disease (OR 2.06 [95% CI 1.67-2.55]; P < 0.0001).
- 139 out of 1,945 participants developed overt cardiovascular disease during follow-up, with 10.2% among those with metabolic syndrome.
- Increased risk of overt cardiovascular disease was noted for participants with metabolic syndrome and subclinical disease (HR 2.67 [1.62-4.41]) compared to those without metabolic syndrome, diabetes, or subclinical disease.
Study Design
Type
Cohort (n=1,945)
Structured PICO
Does the presence of subclinical cardiovascular disease modify the risk of overt cardiovascular disease in individuals with metabolic syndrome or diabetes?
P
Population
1,945 Framingham Offspring Study participants (mean age 58 years; 59% women) followed for a mean of 7.2 years to evaluate the prognostic impact of subclinical cardiovascular disease.
E
Exposure
Presence of metabolic syndrome (MetS) and/or diabetes, stratified by the presence of subclinical cardiovascular disease (assessed via electrocardiography, echocardiography, carotid ultrasound, ankle-brachial blood pressure, and urinary albumin excretion).
C
Comparator
Absence of metabolic syndrome, diabetes, and subclinical cardiovascular disease.
O
Outcome
Incidence of overt cardiovascular disease (CVD).hard clinical
Main Result
Hazard Ratio: 2.67 (95% CI 1.62–4.41)
Subclinical cardiovascular disease is highly prevalent in individuals with metabolic syndrome and is a major driver of their increased risk for developing overt cardiovascular events.
Cite This Study
Ingelsson et al. (2007) conducted a cohort in Metabolic syndrome and diabetes (n=1,945). Metabolic syndrome with subclinical cardiovascular disease vs. Absence of metabolic syndrome, diabetes, or subclinical disease was evaluated on Overt cardiovascular disease (HR 2.67, 95% CI 1.62-4.41). Metabolic syndrome with subclinical cardiovascular disease was associated with an increased risk of overt cardiovascular disease compared to the absence of these conditions (HR 2.67; 95% CI 1.62-4.41).