Metabolic syndrome is independently associated with increased 20-year mortality in patients with stable coronary artery disease.

Abstract

BACKGROUND:

Data regarding long-term association of metabolic syndrome (MetS) with adverse outcomes are conflicting. We aim to determine the independent association of MetS (based on its different definitions) with 20 year all-cause mortality among patients with stable coronary artery disease (CAD).

METHODS:

Our study comprised 15,524 patients who were enrolled in the Bezafibrate Infarction Prevention registry between February 1, 1990, and October 31, 1992, and subsequently followed-up for the long-term mortality through December 31, 2014. MetS was defined according to two definitions: The International Diabetes Federation (IDF); and the National Cholesterol Education Program-Third Adult Treatment Panel (NCEP).

RESULTS:

According to the IDF criteria 2122 (14%) patients had MetS, whereas according to the NCEP definition 7446 (48%) patients had MetS. Kaplan-Meier survival analysis showed that all-cause mortality was significantly higher among patients with MetS defined by both the IDF (67 vs. 61%; log rank-p < 0.001) as well as NCEP (67 vs. 54%; log rank-p < 0.001) criteria. Multivariate adjusted mortality risk was 17% greater [Hazard Ratio (HR) 1.17; 95% Confidence Interval (CI) 1.07-1.28] in patients with MetS according to IDF and 21% (HR 1.21; 95% CI 1.13-1.29) using the NCEP definition. Subgroup analysis demonstrated that long-term increased mortality risk associated with MetS was consistent among most clinical subgroups excepted patients with renal failure (p value for interaction < 0.05).

CONCLUSIONS:

Metabolic syndrome is independently associated with an increased 20-year all-cause mortality risk among patients with stable CAD. This association was consistent when either the IDF or NCEP definitions were used. Trial registration retrospective registered.

• Authors: Arwa Younis, Anan Younis, Boaz Tzur, Yael Peled, Nir Shlomo, Ilan Goldenberg, Enrique Z Fisman, Alexander Tenenbaum, Robert Klempfner
• Journal: Cardiovascular diabetology (Cardiovasc Diabetol) Vol. 15 Issue 1 Pg. 149 (Oct 28 2016) ISSN: 1475-2840 [Electronic] England
• PMID: 27793156 (Publication Type: Journal Article)

Chemical References

• Hypolipidemic Agents
• Bezafibrate

Topics

• Age Factors
• Aged
• Bezafibrate (therapeutic use)
• Chi-Square Distribution
• Coronary Artery Disease (diagnosis, mortality)
• Female
• Humans
• Hypolipidemic Agents (therapeutic use)
• Kaplan-Meier Estimate
• Male
• Metabolic Syndrome (diagnosis, drug therapy, mortality)
• Middle Aged
• Multivariate Analysis
• Prognosis
• Proportional Hazards Models
• Randomized Controlled Trials as Topic
• Registries
• Renal Insufficiency (mortality)
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Time Factors