Abstract 1692: Left Ventricular Mass as a Predictor of Cardiovascular Disease Events in Elderly Subjects With Metabolic Syndrome and Diabetes
Objective: To examine the prognostic significance of left ventricular mass (LV mass) for cardiovascular (CV) events in persons with metabolic syndrome (MetS) and diabetes (DM).
Introduction: Persons with MetS and DM are at a greater risk of CVD events. Whether subclinical CVD evidenced by increased LV mass provides significant incremental prognostic value in predicting events in these persons is unclear.
Methods: We studied 3724 adults aged 65 to 95 (mean age 72.4 ± 5.4, 61.0% female, 4.4% African American) from the Cardiovascular Health Study. Subjects were classified as having MetS according to AHA/NHLBI criteria, DM, or neither condition and had complete risk factor measures and LV mass calculations. We examined the association of LV mass determined by echocardiography with CVD events (including coronary heart disease, congestive heart failure, stroke, and CVD deaths) using Cox proportional hazards regression, adjusted for age, gender, ethnicity, and standard risk factors. The likelihood ratio χ2 test for model fitness examined the incremental value of LV mass above standard risk factors for the prediction of CVD events.
Results: Over a mean follow-up of 10.2 y ± 5.4 years, 1892 subjects experienced at least one CVD event. LV mass mean and standard deviation for those with MetS, DM, or neither are 155.7 ± 28.3, 163.5 ± 31.6, and 142.4 ± 28.4 grams, respectively ( p < 0.0001). Increased LV mass was positively associated with CVD events in persons with and without MetS, but not persons with diabetes. Standard risk factors plus the addition of LV mass provided significantly better fit than a model with risk factors alone for predicting CVD events in those with and without MetS, but not in those with DM.
Conclusions: LV mass is associated with a modest increase in CVD risk and appears to provide incremental clinical utility over standard risk factors in older persons with and without MetS, but not in those with DM.