World Health Organization-Defined Metabolic Syndrome Is a Better Predictor of Coronary Calcium Than the Adult Treatment Panel III Criteria in American Men Aged 40–49 Years

D etection of coronary artery disease,a major cause of death in the U.S., isimportant in primary prevention settings. The noninvasive screening method of electron beam–computed to-mography (EBCT) can be used to quantify coronary arterial calcification (CAC) and identify subjects with subclinical coro-nary artery atherosclerosis (1,2). However, EBCT screenings of all asymptomatic sub-jects is not practical in the clinical setting (3,4). Therefore, identification of high-risk subjects before EBCT evaluation is necessary. Currently, the metabolic syn-drome, a constellation of risk factors, is used to identify high-risk individuals over and above conventional coronary risk fac-tors because of the independent associa-tion of the metabolic syndrome with subsequent development of cardiovascu-lar diseases and diabetes (5–10). The pur-pose of this study was 1) to determine whether risk identification using meta-bolic syndrome as a criterion is useful for the detection of CAC with EBCT and 2) to compare the usefulness of the National