Metabolic syndrome associated with adverse cardiovascular outcome independently of its associations with diabetes and obesity
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The prevalence of the metabolic syndrome defined by NCEP ATP III criteria was assessed in 8397 patients with stable coronary artery disease from the EUROPA trial and the inter-relationships between metabolic syndrome, diabetes, obesity and cardiovascular risk were investigated. The metabolic syndrome, present in 23.4% of the population, significantly predicted outcome with a relative risk (RR) of cardiovascular mortality of 1.82, and of fatal and non-fatal myocardial infarction of 1.50. After adjusting for conventional risk factors and diabetes, the association of the metabolic syndrome with adverse outcomes remained significant with a RR of 1.39. Compared to normal weight subjects without dysmetabolic status, normal weight subjects with either diabetes or metabolic syndrome were at substantially increased risk of cardiovascular death (RR=4.05). The authors recommend routine metabolic evaluation as part of cardiovascular risk assessment of all patients with coronary disease, with or without obesity.
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