ATHEROSCLEROTIC CORONARY ARTERY DISEASE IN PATIENTS WITH CARDIOMETABOLIC SYNDROME: FROM THREE FUKUOKA UNIVERSITY REGISTRY IN JAPAN

Abstract

Abstract Objective: Major coronary risk factors were included in aging, gender, family history, hypertension, diabetes, high cholesterol and smoking. Metabolic syndrome includes abdominal obesity, high blood pressure, high triglyceride (TG) and/or low high-density lipoprotein cholesterol (HDL-C) and diabetes. We determined the critical risk factors for the onset and progression of coronary artery disease (CAD). Design and method: We have been going on three Fukuoka University Registry in Japan to define the risk factors for primary and secondary prevention of atherosclerotic CAD: Coronary Computed Tomography Angiography (FU-CCTA) Registry, Coronary Intravascular Ultrasound (FU-IVUS) Registry and Quantitative Coronary Angiography (FU-QCA) Registry. We analyzed the data from three Registry. Results: First, HDL-C levels were most closely associated with the presence of CAD from the FU-CCTA registry, and we need to perform CCTA for suspected CAD patients with lower HDL-C levels under statin treatment. In addition, in the five groups classified according to the number of metabolic factors, the number of significantly coronary stenosed vessels was significantly increased as the number of metabolic factors increased. Second, we found that among CAD patients treated with statins, TG levels were associated with lipid-rich coronary plaques in females, but not in males according to the FU-IVUS Registry. TG levels may be more important indicators of residual risk after statin treatment in females than in males. Lastly, HDL-C < 40 mg/dl and low-density lipoprotein cholesterol (LDL-C) equal to or more than 100 mg/dl were even more strongly related to major adverse cardiac events in female patients, whereas the combination of LDL-C and HDL-C was not related to MACEs in male patients on the FU-QCA Registry. Conclusions: Although an increased metabolic factors induces more severe CAD and lower HDL-C and higher LDL-C induce the onset and progression of CAD, there may be gender differences in the significance of lipid profiles.