Abstract 4142: Metabolic Syndrome in Patients with CAD: Is it More than Obesity? Analysis of 79,677 Hospitalizations in Get with the Guidelines
BACKGROUND: Metabolic syndrome (Met Syn) is common in the population, but its prevalence and that of its component criteria within the coronary artery disease (CAD) population is less well defined. We investigated whether obesity with Met Syn might be different without Met Syn.
METHODS: The Get With The Guidelines database analyzed all hospitalizations for CAD from 01/00 to 12/05 with data available to classify Met Syn based on modified AHA criteria. Due to available information, BMI (>30) was substituted for waist circumference, and a diagnosis of diabetes was substituted for glucose intolerance.
RESULTS: Of the 79,677 hospitalizations for CAD with data available to classify Met Syn, 47% (37,621) met criteria for Met Syn. Patients with Met Syn were younger, more likely female, and more likely non-Caucasian. In-hospital mortality for patients with Met Syn was significantly lower than for those without (1.7% vs. 2.6%, p<0.0001). However, stratification by obesity revealed other factors that may contribute to differences in mortality (see Table⇓), also observed in those without Met Syn. Patients who were not obese were older, more likely to have other components of Met Syn, and had more co-morbidities independent of Met Syn (PAD, renal insufficiency, and stroke). Both in patients with and without Met Syn, those who were obese had fewer co-morbidities and significantly lower morality. However, in multivariate analyses controlling for age and gender, obesity was no longer a significant predictor of in-hospital mortality, and patients with Met Syn still had significantly lower mortality.
CONCLUSIONS: Met Syn is very common among patients with CAD. Met Syn itself was not associated with adverse early prognosis, though higher short-term mortality was apparent in the group with more components of Met Syn and other co-morbidities. While it may be unclear of the value in the diagnosis of metabolic syndrome, the diagnosis and reporting of the components are important.