Abstract
BackgroundMetabolic syndrome (MS) is a disorder, characterized by clusters of cardiovascular risk factors such as central obesity, insulin resistance, dyslipidemia and hypertension. Patients with MS may have a higher plaque burden that increases their risk of major adverse cardiovascular events (MACEs). This study aimed to analyze the prevalence of high-risk coronary plaques in patients with and without MS by coronary computed tomography angiography (CCTA) and to investigate the relationship between MS, high-risk coronary plaques, and their prognosis.MethodsThis was a retrospective cohort study of 1136 patients who underwent CCTA due to chest pain without obstructive heart disease (≥50% coronary stenosis) between January 2014 and December 2015 in our hospital. The relationships between high risk coronary plaques, MS, and other clinical factors were assessed. Multicollinearity analysis was performed to identify the collinearity between the variables. The proportional hazard assumption was checked and using Schoenfeld residual test. Cox proportional hazards model and Kaplan-Meier survival analysis assessed the relationship between MS, high-risk coronary plaques and MACEs.ResultsHigh-risk plaques were more frequent in the MS group than non-MS group (P = 0.004). MS (HR = 2.128, 95%CI: 1.524–2.970, P < 0.001), presence of high-risk plaques (HR = 11.059, 95%CI: 7.749–57.232, P < 0.001) and high sensitivity C-reactive protein (hsCRP) (HR = 1.629, 95%CI: 1.128–2.352, P = 0.009) were related with an increased risk of MACEs in patients with risk factors for coronary heart disease. In patients with high-risk plaques, MS (HR = 2.265, 95%CI: 1.629–3.150, P < 0.001) and hsCRP (HR = 1.267, 95%CI: 1.191–1.348, P = 0.004) were related with an increased risk of MACEs. Kaplan-Meier analysis showed differences in MACEs between the MS and non-MS groups in the whole population and those with high-risk plaques (both P < 0.0001).ConclusionsHigh-risk plaques were more common in patients with MS. MS and the presence of high-risk plaques were independent risk factors for MACEs.
Highlights
Metabolic syndrome (MS) is a disorder, characterized by clusters of cardiovascular risk factors such as central obesity, insulin resistance, dyslipidemia and hypertension
Metabolic syndrome (MS) occurs when an individual has a few risk factors, such as central obesity, insulin resistance, dyslipidemia and hypertension that together result in an increased risk of type 2 diabetes mellitus and cardiovascular disease [1]
Coronary computed tomography angiography (CCTA) can effectively evaluate the degree of coronary artery stenosis, and analyze the coronary atherosclerotic plaque characteristics to identify high-risk plaques, which has unique advantages compared to other examinations [6]
Summary
Metabolic syndrome (MS) is a disorder, characterized by clusters of cardiovascular risk factors such as central obesity, insulin resistance, dyslipidemia and hypertension. Patients with MS may have a higher plaque burden that increases their risk of major adverse cardiovascular events (MACEs). Metabolic syndrome (MS) occurs when an individual has a few risk factors, such as central obesity, insulin resistance, dyslipidemia and hypertension that together result in an increased risk of type 2 diabetes mellitus and cardiovascular disease [1]. AS may predict major adverse cardiac events (MACEs), a high-risk coronary plaque may progress rapidly and result in acute coronary syndrome [5]. Coronary computed tomography angiography (CCTA) can effectively evaluate the degree of coronary artery stenosis, and analyze the coronary atherosclerotic plaque characteristics to identify high-risk plaques, which has unique advantages compared to other examinations [6]. Detection of high-risk plaques may effectively reduce the occurrence of MACEs [8]
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