Key result
Metabolic syndrome was independently associated with the presence of any coronary plaque (OR 1.55) and obstructive plaque (OR 1.52) in symptomatic non-diabetic subjects, but not in diabetic subjects.
Why the study?
Is metabolic syndrome associated with increased coronary artery disease severity on cardiac CT differently in diabetic versus non-diabetic symptomatic patients?
Cross-Sectional (n=2,869)
No
Is metabolic syndrome associated with increased coronary artery disease severity on cardiac CT differently in diabetic versus non-diabetic symptomatic patients?
Metabolic syndrome is independently associated with the presence and severity of coronary artery disease on cardiac CT only in non-diabetic symptomatic patients, suggesting its incremental prognostic value is attenuated once diabetes is established.
Answers are grounded in this paper and cite their sources.
Supports differential CAD risk stratification by metabolic syndrome only in non-diabetics; leaves open utility once diabetes is established.
BACKGROUND: Metabolic syndrome (MetS) is associated with increased risks of diabetes and coronary artery disease (CAD). Despite the controversial inclusion of established diabetes in MetS, the association between MetS and CAD according to diabetes status has not been elucidated in the Asian population. METHODS: We evaluated the association between MetS and CAD using the parameters including any plaque, obstructive plaque, and coronary artery calcium score (CACS) >100 according to diabetes status in 2,869 symptomatic Korean subjects who underwent cardiac computed tomographic angiography. RESULTS: The prevalence of MetS was significantly higher in the diabetic subjects than in the non-diabetic subjects (69% vs. 34%, P <0.001). The incidence of any plaque (64% vs. 43%, P <0.001), obstructive plaque (26% vs. 13%, P = 0.006), and CACS >100 (23% vs. 12%, P = 0.012) was significantly higher in diabetic subjects than in non-diabetic subjects. Among the MetS components, decreased high-density lipoprotein level was significantly associated with any plaque (odds ratio [OR] 1.35), obstructive plaque (OR 1.55), and CACS >100 (OR 1.57) in the non-diabetic subjects (P <0.01, respectively). However, none of the MetS components were associated with all the parameters in the diabetic subjects. Multivariate regression analysis revealed that MetS and the number of MetS components (MetSN) were independently associated with any plaque (MetS: OR 1.55, P <0.001; MetSN: OR 1.22, P <0.001), obstructive plaque (MetS: OR 1.52, P = 0.003; MetSN: OR 1.25, P <0.001), and CACS >100 (MetS: OR 1.46, P = 0.015; MetSN: OR 1.21, P = 0.004) only in the non-diabetic subjects, respectively. CONCLUSIONS: MetS was independently associated with the presence and severity of CAD only in the non-diabetic subjects among the symptomatic Korean population.
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Won et al. (2014) conducted a cross-sectional in Coronary artery disease (n=2,869). Metabolic syndrome vs. No metabolic syndrome was evaluated on Presence of any coronary plaque in non-diabetic subjects (OR 1.55, 95% CI 1.27-1.89, p=<0.001). Metabolic syndrome was independently associated with the presence of any coronary plaque (OR 1.55) and obstructive plaque (OR 1.52) in symptomatic non-diabetic subjects, but not in diabetic subjects.
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