Abstract 1247: Comparison of Metabolic Syndrome and Diabetes in Predicting Long-term all-cause Mortality
Metabolic syndrome (MetS) confers an increased risk of death. However, the prognostic value of MetS in comparison to type 2 diabetes mellitus (DM), a cardiovascular disease risk-equivalent, is unclear. Moreover, whether MetS adds incrementally to the prognostic value of DM is not known. In 47,166 consecutive patients (35.6% women) referred to the Cardiovascular Health Clinic for treadmill exercise test between 1993 and 2003, we compared all-cause mortality in patients without MetS and DM at baseline to those with MetS and with DM (without MetS). MetS was defined by modified National Cholesterol Education Program criteria. Mean age was 54.9 ± 13 yrs. During an average follow-up of 8.2 ± 3.6 years, 4175 (8.8%) deaths were identified. Prevalence of MetS was 34%. Using Cox proportional-hazards regression, adjusted for age, gender and smoking, hazard ratios (HR) for all cause mortality were significantly higher in patients with DM (HR=1.60 [95% CI, 1.30 –1.95]) than those with MetS (HR=1.14 [95% CI, 1.14 –1.21]). No significant difference in mortality was observed among patients with DM and those with MetS (with DM; p=0.31). In patients referred for exercise testing, DM was a stronger predictor of all-cause morality compared to MetS. Presence of MetS and DM together did not provide incremental prognostic value to DM alone.