Abstract 12037: Discordant Effects of Metabolic Syndrome and Central Obesity on Mortality in Stable Coronary Heart Disease
Background: Metabolic syndrome (MetS) is associated with an increased risk of developing type 2 diabetes mellitus and major cardiovascular events. However, in light of the “obesity paradox,” where overweight/obese patients with coronary heart disease (CHD) have a better prognosis than do leaner patients, the impact of MetS on prognosis in CHD is largely unknown.
Patients & Methods: We evaluated 392 consecutive patients with stable CHD (241 with MetS and 151 without MetS) to determine the impact of standard CHD risk factors, including central obesity or waist circumference (WC; High is ≥ 40” in men and ≥ 35” in women), on 3-year mortality.
Results: During 3-year follow-up, mortality trended higher in those with MetS (4.6% vs 1.9%; p=0.18). However, the group with MetS but Low WC (n=48) had a nearly 6-fold higher mortality (12.5%) vs all others combined (2.3%; p=0.0004; Figure). In multivariate analysis, MetS was not an independent predictor of mortality (OR 1.87; CI 0.50-7.0), whereas High WC as a continuous variable was an independent predictor of lower mortality (OR 0.86; CI 0.75-0.99).
Conclusions: Although MetS was associated with a trend to higher mortality, this was not significant in univariate or multivariate analyses. On the other hand, central obesity appeared to be protective in patients with MetS, supporting the “obesity paradox,” and those with MetS and Low WC had the highest mortality risk during follow-up. Figure Legend 3-year mortality in 392 patients divided into 4 groups by metabolic syndrome (MetS) and by High (≥ 40” in men and ≥ 35” in women) and Low Waist Circumference (WC).
- © 2011 by American Heart Association, Inc.