This study by Butler et al. examined whether the metabolic syndrome was associated with the presence and extent of both calcified and noncalcified coronary atherosclerotic plaques and whether this association was maintained after adjusting for other cardiovascular risk factors. For that purpose, 77 patients (aged 54 ± 12 years) underwent multidetector computed tomography (MDCT) to detect both calcified and noncalcified coronary plaques. Patients were classified as those who did (n=35; 45%) and did not (n=42; 55%) have the metabolic syndrome using the modified National Cholesterol Education Program-Adult Treatment Panel III clinical criteria. Study findings showed that patients with the metabolic syndrome were more likely to have plaque and a greater extent of plaque distribution compared to patients without the metabolic syndrome. The authors also documented an independent association of the metabolic syndrome with both the presence and extent of plaques after adjusting for the Framingham risk score used as a continuous variable [odds ratio: 6.7 (95% CI, 1.6-28.8; p<0.01) for presence and β coefficient: 3.59 ± 0.88; p<0.009 for extent)]. The metabolic syndrome remained significantly and independently associated with the presence and extent of any plaque [(odds ratio: 8.4 (95% CI 1.7-42.5; p=0.008) for presence and β coefficient 2.35±0.86, p=0.007 for extent)] after adjusting for traditional risk factors (age, gender, smoking, body mass index, hypertension, diabetes, hyperlipidemia, and coronary artery disease). This study therefore provides some direct coronary imaging evidence of increased atherosclerosis in patients with the metabolic syndrome after controlling for the common risk factors.
Documentation centre