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All-cause mortality risk predictors in a preventive cardiology clinic cohort-examining diabetes and individual metabolic syndrome criteria: a PRECIS database study.
Diabetes Obes Metab 2009; 11(2):102-8DO

Abstract

AIM

It is unclear if metabolic syndrome (MS) is equal to type 2 diabetes mellitus (DM) in predicting cardiovascular disease (CVD) risk and mortality, and its prognostic value compared to Framingham risk model is controversial. We assessed mortality, CVD risk and prevalence in patients with DM and those without DM who met National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) MS criteria compared to patients without DM or MS. We analysed which component(s) of NCEP MS criteria had greatest predictive value for mortality.

METHODS

Retrospective cohort analysis of 1189 DM, 1241 MS (fasting glucose < 126 mg/dl and > or =3 components NCEP-ATP III criteria) and 3023 non-DM/non-MS patients presented for baseline visit to Preventive Cardiology clinic between 1995 and 2006, whose subsequent vital status was determined for a median of 5.2 years. The association with mortality was determined by Cox proportional hazards models. The incremental predictive value of MS components was performed by concordance indexes.

RESULTS AND CONCLUSION

DM group had highest mortality and CVD prevalence vs. MS and non-DM/non-MS groups respectively (all p < or = 0.001). Patients with MS criteria had increased CVD prevalence and 1.5-fold increased mortality vs. non-DM/non-MS group (all p < 0.02). In NCEP MS criteria, only fasting glucose significantly predicted mortality in MS group (p = 0.05). MS criteria predicted CVD prevalence in a parallel manner to Framingham risk score assessment. In a cohort of patients at high risk for CVD whose risk factors are being treated, presence of diabetes in addition to plasma glucose within NCEP MS criteria strongly predicts all-cause mortality.

Authors+Show Affiliations

Department of Endocrinology, Diabetes and Metabolism, The Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio 44195, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18494803

Citation

Doshi, K B., et al. "All-cause Mortality Risk Predictors in a Preventive Cardiology Clinic Cohort-examining Diabetes and Individual Metabolic Syndrome Criteria: a PRECIS Database Study." Diabetes, Obesity & Metabolism, vol. 11, no. 2, 2009, pp. 102-8.
Doshi KB, Kashyap SR, Brennan DM, et al. All-cause mortality risk predictors in a preventive cardiology clinic cohort-examining diabetes and individual metabolic syndrome criteria: a PRECIS database study. Diabetes Obes Metab. 2009;11(2):102-8.
Doshi, K. B., Kashyap, S. R., Brennan, D. M., Hoar, B. M., Cho, L., & Hoogwerf, B. J. (2009). All-cause mortality risk predictors in a preventive cardiology clinic cohort-examining diabetes and individual metabolic syndrome criteria: a PRECIS database study. Diabetes, Obesity & Metabolism, 11(2), pp. 102-8. doi:10.1111/j.1463-1326.2008.00908.x.
Doshi KB, et al. All-cause Mortality Risk Predictors in a Preventive Cardiology Clinic Cohort-examining Diabetes and Individual Metabolic Syndrome Criteria: a PRECIS Database Study. Diabetes Obes Metab. 2009;11(2):102-8. PubMed PMID: 18494803.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - All-cause mortality risk predictors in a preventive cardiology clinic cohort-examining diabetes and individual metabolic syndrome criteria: a PRECIS database study. AU - Doshi,K B, AU - Kashyap,S R, AU - Brennan,D M, AU - Hoar,B M, AU - Cho,L, AU - Hoogwerf,B J, Y1 - 2008/05/20/ PY - 2008/5/23/pubmed PY - 2009/8/6/medline PY - 2008/5/23/entrez SP - 102 EP - 8 JF - Diabetes, obesity & metabolism JO - Diabetes Obes Metab VL - 11 IS - 2 N2 - AIM: It is unclear if metabolic syndrome (MS) is equal to type 2 diabetes mellitus (DM) in predicting cardiovascular disease (CVD) risk and mortality, and its prognostic value compared to Framingham risk model is controversial. We assessed mortality, CVD risk and prevalence in patients with DM and those without DM who met National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) MS criteria compared to patients without DM or MS. We analysed which component(s) of NCEP MS criteria had greatest predictive value for mortality. METHODS: Retrospective cohort analysis of 1189 DM, 1241 MS (fasting glucose < 126 mg/dl and > or =3 components NCEP-ATP III criteria) and 3023 non-DM/non-MS patients presented for baseline visit to Preventive Cardiology clinic between 1995 and 2006, whose subsequent vital status was determined for a median of 5.2 years. The association with mortality was determined by Cox proportional hazards models. The incremental predictive value of MS components was performed by concordance indexes. RESULTS AND CONCLUSION: DM group had highest mortality and CVD prevalence vs. MS and non-DM/non-MS groups respectively (all p < or = 0.001). Patients with MS criteria had increased CVD prevalence and 1.5-fold increased mortality vs. non-DM/non-MS group (all p < 0.02). In NCEP MS criteria, only fasting glucose significantly predicted mortality in MS group (p = 0.05). MS criteria predicted CVD prevalence in a parallel manner to Framingham risk score assessment. In a cohort of patients at high risk for CVD whose risk factors are being treated, presence of diabetes in addition to plasma glucose within NCEP MS criteria strongly predicts all-cause mortality. SN - 1463-1326 UR - https://www.unboundmedicine.com/medline/citation/18494803/All_cause_mortality_risk_predictors_in_a_preventive_cardiology_clinic_cohort_examining_diabetes_and_individual_metabolic_syndrome_criteria:_a_PRECIS_database_study_ L2 - https://doi.org/10.1111/j.1463-1326.2008.00908.x DB - PRIME DP - Unbound Medicine ER -