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Published in: The International Journal of Cardiovascular Imaging 2/2013

01-12-2013 | Original Paper

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

Authors: Jaeil Ryu, Hwan Seok Yong, Sik Huh, Eun-Young Kang, Ok Hee Woo

Published in: The International Journal of Cardiovascular Imaging | Special Issue 2/2013

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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.
Literature
2.
go back to reference 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):2486–2497 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):2486–2497
3.
go back to reference 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):683–689PubMedCrossRef 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):683–689PubMedCrossRef
4.
go back to reference Reaven G (2002) Metabolic syndrome: pathophysiology and implications for management of cardiovascular disease. Circulation 106(3):286–288PubMedCrossRef Reaven G (2002) Metabolic syndrome: pathophysiology and implications for management of cardiovascular disease. Circulation 106(3):286–288PubMedCrossRef
5.
go back to reference 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):2709–2716PubMedCrossRef 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):2709–2716PubMedCrossRef
6.
go back to reference 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 PubMedCrossRef 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 PubMedCrossRef
7.
go back to reference 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):1547–1553PubMedCrossRef 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):1547–1553PubMedCrossRef
9.
10.
go back to reference 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 PubMedCrossRef 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 PubMedCrossRef
11.
go back to reference 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 CrossRef 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 CrossRef
12.
go back to reference 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 PubMedCrossRef 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 PubMedCrossRef
13.
go back to reference Hitsumoto T, Takahashi M, Iizuka T, Shirai K (2007) Relationship between metabolic syndrome and early stage coronary atherosclerosis. J Atheroscler Thromb 14(6):294–302PubMedCrossRef Hitsumoto T, Takahashi M, Iizuka T, Shirai K (2007) Relationship between metabolic syndrome and early stage coronary atherosclerosis. J Atheroscler Thromb 14(6):294–302PubMedCrossRef
14.
16.
go back to reference Mitsutake R, Miura S, Kawamura A, Saku K (2009) Are metabolic factors associated with coronary artery stenosis on MDCT? Circ J 73(1):132–138PubMedCrossRef Mitsutake R, Miura S, Kawamura A, Saku K (2009) Are metabolic factors associated with coronary artery stenosis on MDCT? Circ J 73(1):132–138PubMedCrossRef
17.
go back to reference 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):5–40PubMedCrossRef 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):5–40PubMedCrossRef
18.
go back to reference 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 PubMedCrossRef 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 PubMedCrossRef
19.
go back to reference 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 PubMedCrossRef 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 PubMedCrossRef
20.
go back to reference 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):2157–2162PubMedCrossRef 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):2157–2162PubMedCrossRef
21.
go back to reference 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 PubMedCrossRef 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 PubMedCrossRef
22.
23.
go back to reference 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 PubMedCrossRef 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 PubMedCrossRef
Metadata
Title
Relation of coronary atherosclerosis and metabolic syndrome in asymptomatic subjects: evaluation with coronary CT angiography
Authors
Jaeil Ryu
Hwan Seok Yong
Sik Huh
Eun-Young Kang
Ok Hee Woo
Publication date
01-12-2013
Publisher
Springer Netherlands
Published in
The International Journal of Cardiovascular Imaging / Issue Special Issue 2/2013
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-013-0319-2

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