Abstract 4143: Relationship of Diabetes Mellitus, Metabolic Syndrome, or Neither Condition with Survival in Patients with a New Diagnosis of Coronary Artery Disease
Introduction: Metabolic Syndrome (MS) is associated with increased risk of cardiovascular disease. The effect of MS on survival in non-diabetic patients with coronary artery disease (CAD) is not well defined.
Methods: We identified patients with a new diagnosis of significant CAD on angiogram between 1998 and 2001 in the Duke Database for Cardiovascular Disease. Diabetes Mellitus (DM) was classified as a clinical history of DM, outpatient use of hypoglycemic drugs, or a fasting glucose of ≥126 mg/dL. MS was classified as having 3 of 5 characteristics: fasting glucose ≥110 and <126 mg/dL, low HDL (<35 mg/dL male, <40 mg/dL female), triglycerides >150 mg/dL, clinical history of hypertension or BMI ≥27. Follow up for death was obtained every 6 months. Cox proportional hazards models were built using stepwise selection of survival predictors.
Results: We identified 6522 patients with a new diagnosis of CAD. 5994 could be classified as DM (1952), MS (2116) or No DM/MS (1926). MS patients were younger and received more statins than No DM/MS patients. Median follow up was 5 years. Significant independent predictors of mortality included age, sex, Charlson Index, revascularization, ejection fraction, NYHA class, DM, valve disease, systolic blood pressure, smoking, CAD extent, peripheral and cerebrovascular disease, and statin use. Compared with no DM/MS, MS alone was not a predictor of increased mortality (Hazard Ratio (HR) 0.95; 95% Confidence Interval (CI) [0.82, 1.09]) but DM was (HR 1.54; 95% CI [1.36, 1.76]) (Figure⇓).
Conclusions: In a population of consecutive patients with a new diagnosis of CAD by angiography, DM but not MS alone is independently associated with increased mortality.