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Relation of coronary atherosclerosis and metabolic syndrome in asymptomatic subjects: evaluation with coronary CT angiography

  • Jaeil Ryu
  • Hwan Seok Yong
  • Sik Huh
  • Eun-Young Kang
  • Ok Hee Woo
Original Paper

Abstract

To assess the relationship between metabolic syndrome (MetS) and coronary atherosclerosis using coronary CT angiography (CCTA) as the evaluation tool in asymptomatic cardiovascular disease (CVD) free subjects. The presence and extent of coronary atherosclerosis in 755 asymptomatic self-referred subjects were measured using CCTA. The relationships between coronary atherosclerosis, MetS, and other clinical factors were assessed. To further investigate the relationship between MetS and the presence and extent of coronary plaque, subjects were divided into 3 subgroups according to the number of metabolic factors (MF0, 1–2 or ≥3) and the number of coronary segments with plaque (segment involvement score: SIS0, 1, ≥2). MetS showed significant association with the presence of coronary plaque after adjustment for other clinical factors [odds radio (OR) 1.791 (1.159–2.775), P = 0.009]. Among metabolic components, abdominal obesity and high blood pressure were significantly associated with the presence of coronary plaque [OR 1.708 (1.189–2.455), P = 0.004; OR 1.677 (1.165–2.415), P = 0.005]. Coronary plaque was more frequently found in subgroups with a higher number of metabolic factors (32.4, 36.7 and 52.1 %). Higher SISs were also found in subjects with more MetS components (SIS1: 14.6, 16.2 and 27.2 %; SIS ≥ 2: 17, 19.7 and 23.7 %). In asymptomatic CVD free subjects, MetS and number of metabolic factors were related with an increased risk of the presence and the extent of coronary plaque. Abdominal obesity and high blood pressure were significantly associated with the presence of coronary plaque.

Keywords

Metabolic syndrome Coronary CT angiography Atherosclerosis Coronary artery disease 

Notes

Conflict of interest

The authors have no financial conflicts of interest.

References

  1. 1.
    Park HS, Kim SM, Lee JS, Lee J, Han JH, Yoon DK, Baik SH, Choi DS, Choi KM (2007) Prevalence and trends of metabolic syndrome in Korea: Korean National Health and Nutrition Survey 1998–2001. Diabetes Obes Metab 9(1):50–58. doi: 10.1111/j.1463-1326.2005.00569.x PubMedCrossRefGoogle Scholar
  2. 2.
    Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 285(19):2486–2497Google Scholar
  3. 3.
    Isomaa B, Almgren P, Tuomi T, Forsén B, Lahti K, Nissén M, Taskinen MR, Groop L (2001) Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 24(4):683–689PubMedCrossRefGoogle Scholar
  4. 4.
    Reaven G (2002) Metabolic syndrome: pathophysiology and implications for management of cardiovascular disease. Circulation 106(3):286–288PubMedCrossRefGoogle Scholar
  5. 5.
    Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT (2002) The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 288(21):2709–2716PubMedCrossRefGoogle Scholar
  6. 6.
    Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, Montori VM (2007) Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 49(4):403–414. doi: 10.1016/j.jacc.2006.09.032 PubMedCrossRefGoogle Scholar
  7. 7.
    Wong ND, Sciammarella MG, Polk D, Gallagher A, Miranda-Peats L, Whitcomb B, Hachamovitch R, Friedman JD, Hayes S, Berman DS (2003) The metabolic syndrome, diabetes, and subclinical atherosclerosis assessed by coronary calcium. J Am Coll Cardiol 41(9):1547–1553PubMedCrossRefGoogle Scholar
  8. 8.
    Kullo IJ, Cassidy AE, Peyser PA, Turner ST, Sheedy PF 2nd, Bielak LF (2004) Association between metabolic syndrome and subclinical coronary atherosclerosis in asymptomatic adults. Am J Cardiol 94(12):1554–1558. doi: 10.1016/j.amjcard.2004.08.038 PubMedCrossRefGoogle Scholar
  9. 9.
    Ellison RC, Zhang Y, Wagenknecht LE, Eckfeldt JH, Hopkins PN, Pankow JS, Djousse L, Carr JJ (2005) Relation of the metabolic syndrome to calcified atherosclerotic plaque in the coronary arteries and aorta. Am J Cardiol 95(10):1180–1186. doi: 10.1016/j.amjcard.2005.01.046 PubMedCrossRefGoogle Scholar
  10. 10.
    Campbell CY, Nasir K, Sarwar A, Meneghelo RS, Carvalho JA, Blumenthal RS, Santos RD (2007) Combined effect of high low-density lipoprotein cholesterol and metabolic syndrome on subclinical coronary atherosclerosis in white men without clinical evidence of myocardial ischemia. Am J Cardiol 100(5):840–843. doi: 10.1016/j.amjcard.2007.04.018 PubMedCrossRefGoogle Scholar
  11. 11.
    Chen K, Lindsey JB, Khera A, De Lemos JA, Ayers CR, Goyal A, Vega GL, Murphy SA, Grundy SM, McGuire DK (2008) Independent associations between metabolic syndrome, diabetes mellitus and atherosclerosis: observations from the Dallas Heart Study. Diabetes Vasc Dis Res 5(2):96–101. doi: 10.3132/dvdr.2008.016 CrossRefGoogle Scholar
  12. 12.
    Bertoni AG, Wong ND, Shea S, Ma S, Liu K, Preethi S, Jacobs DR Jr, Wu C, Saad MF, Szklo M (2007) Insulin resistance, metabolic syndrome, and subclinical atherosclerosis: the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care 30(11):2951–2956. doi: 10.2337/dc07-1042 PubMedCrossRefGoogle Scholar
  13. 13.
    Hitsumoto T, Takahashi M, Iizuka T, Shirai K (2007) Relationship between metabolic syndrome and early stage coronary atherosclerosis. J Atheroscler Thromb 14(6):294–302PubMedCrossRefGoogle Scholar
  14. 14.
    Tzou WS, Douglas PS, Srinivasan SR, Bond MG, Tang R, Chen W, Berenson GS, Stein JH (2005) Increased subclinical atherosclerosis in young adults with metabolic syndrome: the Bogalusa Heart Study. J Am Coll Cardiol 46(3):457–463. doi: 10.1016/j.jacc.2005.04.046 PubMedCrossRefGoogle Scholar
  15. 15.
    Butler J, Mooyaart EA, Dannemann N, Bamberg F, Shapiro MD, Ferencik M, Brady TJ, Hoffmann U (2008) Relation of the metabolic syndrome to quantity of coronary atherosclerotic plaque. Am J Cardiol 101(8):1127–1130. doi: 10.1016/j.amjcard.2007.12.012 PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Mitsutake R, Miura S, Kawamura A, Saku K (2009) Are metabolic factors associated with coronary artery stenosis on MDCT? Circ J 73(1):132–138PubMedCrossRefGoogle Scholar
  17. 17.
    Austen WG, Edwards JE, Frye RL, Gensini GG, Gott VL, Griffith LS, McGoon DC, Murphy ML, Roe BB (1975) A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 51(4):5–40PubMedCrossRefGoogle Scholar
  18. 18.
    Leber AW, Becker A, Knez A, von Ziegler F, Sirol M, Nikolaou K, Ohnesorge B, Fayad ZA, Becker CR, Reiser M, Steinbeck G, Boekstegers P (2006) Accuracy of 64-slice computed tomography to classify and quantify plaque volumes in the proximal coronary system: a comparative study using intravascular ultrasound. J Am Coll Cardiol 47(3):672–677. doi: 10.1016/j.jacc.2005.10.058 PubMedCrossRefGoogle Scholar
  19. 19.
    Min JK, Shaw LJ, Devereux RB, Okin PM, Weinsaft JW, Russo DJ, Lippolis NJ, Berman DS, Callister TQ (2007) Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality. J Am Coll Cardiol 50(12):1161–1170. doi: 10.1016/j.jacc.2007.03.067 PubMedCrossRefGoogle Scholar
  20. 20.
    Rumberger JA, Simons DB, Fitzpatrick LA, Sheedy PF, Schwartz RS (1995) Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area. A histopathologic correlative study. Circulation 92(8):2157–2162PubMedCrossRefGoogle Scholar
  21. 21.
    Bauer RW, Thilo C, Chiaramida SA, Vogl TJ, Costello P, Schoepf UJ (2009) Noncalcified atherosclerotic plaque burden at coronary CT angiography: a better predictor of ischemia at stress myocardial perfusion imaging than calcium score and stenosis severity. AJR Am J Roentgenol 193(2):410–418. doi: 10.2214/AJR.08.1277 PubMedCrossRefGoogle Scholar
  22. 22.
    Falk E, Shah PK, Fuster V (1995) Coronary plaque disruption. Circulation 92(3):657–671PubMedCrossRefGoogle Scholar
  23. 23.
    Lim S, Shin H, Lee Y, Yoon JW, Kang SM, Choi SH, Park KS, Jang HC, Choi SI, Chun EJ (2011) Effect of metabolic syndrome on coronary artery stenosis and plaque characteristics as assessed with 64-detector row cardiac CT. Radiology 261(2):437–445. doi: 10.1148/radiol.11101725 PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Jaeil Ryu
    • 1
  • Hwan Seok Yong
    • 1
  • Sik Huh
    • 1
  • Eun-Young Kang
    • 1
  • Ok Hee Woo
    • 1
  1. 1.Department of Radiology, Korea University Guro HospitalKorea University College of MedicineSeoulKorea

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