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Metabolic syndrome is independently associated with increased 20-year mortality in patients with stable coronary artery disease.
Cardiovasc Diabetol. 2016 Oct 28; 15(1):149.CD

Abstract

BACKGROUND

Data regarding long-term association of metabolic syndrome (MetS) with adverse outcomes are conflicting. We aim to determine the independent association of MetS (based on its different definitions) with 20 year all-cause mortality among patients with stable coronary artery disease (CAD).

METHODS

Our study comprised 15,524 patients who were enrolled in the Bezafibrate Infarction Prevention registry between February 1, 1990, and October 31, 1992, and subsequently followed-up for the long-term mortality through December 31, 2014. MetS was defined according to two definitions: The International Diabetes Federation (IDF); and the National Cholesterol Education Program-Third Adult Treatment Panel (NCEP).

RESULTS

According to the IDF criteria 2122 (14%) patients had MetS, whereas according to the NCEP definition 7446 (48%) patients had MetS. Kaplan-Meier survival analysis showed that all-cause mortality was significantly higher among patients with MetS defined by both the IDF (67 vs. 61%; log rank-p < 0.001) as well as NCEP (67 vs. 54%; log rank-p < 0.001) criteria. Multivariate adjusted mortality risk was 17% greater [Hazard Ratio (HR) 1.17; 95% Confidence Interval (CI) 1.07-1.28] in patients with MetS according to IDF and 21% (HR 1.21; 95% CI 1.13-1.29) using the NCEP definition. Subgroup analysis demonstrated that long-term increased mortality risk associated with MetS was consistent among most clinical subgroups excepted patients with renal failure (p value for interaction < 0.05).

CONCLUSIONS

Metabolic syndrome is independently associated with an increased 20-year all-cause mortality risk among patients with stable CAD. This association was consistent when either the IDF or NCEP definitions were used. Trial registration retrospective registered.

Authors+Show Affiliations

The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel. or.younis@gmail.com.The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel.The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel.The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel.The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel.The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel. Sakler School of Medicine, Tel Aviv University, Ramat Gan, Israel. Heart Research Follow-up Program, University of Rochester, Rochester, NY, USA.Sakler School of Medicine, Tel Aviv University, Ramat Gan, Israel. Cardiovascular Diabetology Research Foundation, Holon, Israel.The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel. Sakler School of Medicine, Tel Aviv University, Ramat Gan, Israel. Cardiovascular Diabetology Research Foundation, Holon, Israel.The Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Sheba Road 2, 52620, Ramat Gan, Israel. Sakler School of Medicine, Tel Aviv University, Ramat Gan, Israel.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27793156

Citation

Younis, Arwa, et al. "Metabolic Syndrome Is Independently Associated With Increased 20-year Mortality in Patients With Stable Coronary Artery Disease." Cardiovascular Diabetology, vol. 15, no. 1, 2016, p. 149.
Younis A, Younis A, Tzur B, et al. Metabolic syndrome is independently associated with increased 20-year mortality in patients with stable coronary artery disease. Cardiovasc Diabetol. 2016;15(1):149.
Younis, A., Younis, A., Tzur, B., Peled, Y., Shlomo, N., Goldenberg, I., Fisman, E. Z., Tenenbaum, A., & Klempfner, R. (2016). Metabolic syndrome is independently associated with increased 20-year mortality in patients with stable coronary artery disease. Cardiovascular Diabetology, 15(1), 149.
Younis A, et al. Metabolic Syndrome Is Independently Associated With Increased 20-year Mortality in Patients With Stable Coronary Artery Disease. Cardiovasc Diabetol. 2016 Oct 28;15(1):149. PubMed PMID: 27793156.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolic syndrome is independently associated with increased 20-year mortality in patients with stable coronary artery disease. AU - Younis,Arwa, AU - Younis,Anan, AU - Tzur,Boaz, AU - Peled,Yael, AU - Shlomo,Nir, AU - Goldenberg,Ilan, AU - Fisman,Enrique Z, AU - Tenenbaum,Alexander, AU - Klempfner,Robert, Y1 - 2016/10/28/ PY - 2016/07/21/received PY - 2016/10/20/accepted PY - 2016/10/30/pubmed PY - 2017/2/14/medline PY - 2016/10/30/entrez KW - All-cause mortality KW - Long term outcomes KW - Metabolic syndrome KW - Prognosis KW - Stable coronary artery disease SP - 149 EP - 149 JF - Cardiovascular diabetology JO - Cardiovasc Diabetol VL - 15 IS - 1 N2 - BACKGROUND: Data regarding long-term association of metabolic syndrome (MetS) with adverse outcomes are conflicting. We aim to determine the independent association of MetS (based on its different definitions) with 20 year all-cause mortality among patients with stable coronary artery disease (CAD). METHODS: Our study comprised 15,524 patients who were enrolled in the Bezafibrate Infarction Prevention registry between February 1, 1990, and October 31, 1992, and subsequently followed-up for the long-term mortality through December 31, 2014. MetS was defined according to two definitions: The International Diabetes Federation (IDF); and the National Cholesterol Education Program-Third Adult Treatment Panel (NCEP). RESULTS: According to the IDF criteria 2122 (14%) patients had MetS, whereas according to the NCEP definition 7446 (48%) patients had MetS. Kaplan-Meier survival analysis showed that all-cause mortality was significantly higher among patients with MetS defined by both the IDF (67 vs. 61%; log rank-p < 0.001) as well as NCEP (67 vs. 54%; log rank-p < 0.001) criteria. Multivariate adjusted mortality risk was 17% greater [Hazard Ratio (HR) 1.17; 95% Confidence Interval (CI) 1.07-1.28] in patients with MetS according to IDF and 21% (HR 1.21; 95% CI 1.13-1.29) using the NCEP definition. Subgroup analysis demonstrated that long-term increased mortality risk associated with MetS was consistent among most clinical subgroups excepted patients with renal failure (p value for interaction < 0.05). CONCLUSIONS: Metabolic syndrome is independently associated with an increased 20-year all-cause mortality risk among patients with stable CAD. This association was consistent when either the IDF or NCEP definitions were used. Trial registration retrospective registered. SN - 1475-2840 UR - https://www.unboundmedicine.com/medline/citation/27793156/Metabolic_syndrome_is_independently_associated_with_increased_20_year_mortality_in_patients_with_stable_coronary_artery_disease_ L2 - https://cardiab.biomedcentral.com/articles/10.1186/s12933-016-0466-6 DB - PRIME DP - Unbound Medicine ER -