Metabolic Syndrome Modifies the Cardiovascular Risk Associated With Angiographic Coronary Artery Disease in Women: A Report From the Women’s Ischemia Syndrome Evaluation
Abstract
Background— The metabolic syndrome, which is characterized by a constellation of fasting hyperglycemia, hypertriglyceridemia, low HDL cholesterol, hypertension, and/or abdominal obesity, is a risk factor for the development of coronary artery disease (CAD) and cardiovascular events. The interrelationship between metabolic status and CAD on cardiovascular risk in women is not known. Methods and Results— We evaluated interrelationships between angiographic CAD, the metabolic syndrome, and incident cardiovascular events among 755 women from the Women’s Ischemia Syndrome Evaluation (WISE) study who were referred for coronary angiography to evaluate suspected myocardial ischemia; 25% of the cohort had the metabolic syndrome at study entry. Compared with women with normal metabolic status, women with the metabolic syndrome had a significantly lower 4-year survival rate (94.3% versus 97.8%, P =0.03) and event-free survival from major adverse cardiovascular events (death, nonfatal myocardial infarction, stroke, or congestive heart failure; 87.8% versus 93.5%, P =0.003). When the subjects were stratified by the presence or absence of angiographically significant CAD at study entry, in women with angiographically significant CAD, the metabolic syndrome resulted in significantly higher risk of cardiovascular events than in women with normal metabolic status (hazard ratio 4.93, 95% CI 1.02 to 23.76; P =0.05), whereas it did not result in increased 4-year cardiovascular risk in women without angiographically significant CAD (hazard ratio 1.41, 95% CI 0.32 to 6.32; P =0.65). Conclusions— These data suggest that in women with suspected myocardial ischemia, the metabolic syndrome modifies the cardiovascular risk associated with angiographic CAD. Specifically, the metabolic syndrome was found to be a predictor of 4-year cardiovascular risk only when associated with significant angiographic CAD.
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The WISE study found that MS was predictive of cardiovascular events only in women with significant atherosclerotic disease.
“The Women's Ischemic Syndrome Evaluation study, an observational study of cardiovascular outcomes in women with angiographically defined coronary disease, found that the MS was predictive of cardiovascular events only in women with significant atherosclerotic disease.32”
From Diabetes, the Metabolic Syndrome, and Angiographic Progression of Coronary Arterial Disease in Postmenopausal Women (2006) · cites this paper as [32]
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- Authors
- Marroquin, O. C., Kip, K. E., Kelley, D. E., Johnson, B. D., Shaw, L. J., Bairey Merz, C. N., Sharaf, B. L., Pepine, C. J., Sopko, G., & Reis, S. E.
- Affiliations
- Cedars-Sinai Medical Center (US)
- From the Cardiovascular Institute (O.C.M., S.E.R.), Department of Epidemiology (K.E.K., B.D.J.), and the Division of Endocrinology (D.E.K.), the University of Pittsburgh, Pittsburgh, Pa; Emory University (L.J.S.), Department of Health Policy & Management, Rollins School of Public Health, Atlanta, Ga; Division of Cardiology, Cedars-Sinai Medical Center (C.N.B.M.), Los Angeles, Calif; Division of Cardiology, Rhode Island Hospital (B.L.S.), Providence, RI; Division of Cardiology, University of...
- Venue
- Circulation
- Published
- 2004-02-17
- Volume
- 109
- Issue
- 6
- Pages
- 714-721
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2105025016
- Cited by
- 243
- References
- 21
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 1 · 2022: 5 · 2021: 2 · 2020: 4 · 2019: 1 · 2018: 4 · 2017: 5 · 2016: 12 · 2015: 14 · 2014: 7 · 2013: 7 · 2012: 18
- FWCI
- 19.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hv068164-006, n01hv068162-009, n01hv068161-005, n01hv068163-006)
- National Heart, Lung, and Blood Institute (N01-HV68162, N01 HV 68161, N01HV68163, N01-HV68164)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- metabolic syndrome, coronary artery disease, cardiovascular risk, women, myocardial ischemia, major adverse cardiovascular events, survival, Women's Ischemia Syndrome Evaluation, coronary angiography, risk factor control
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Coronary Artery Disease, Female, Humans, Insulin Resistance, Middle Aged, Prospective Studies, Risk Factors, Incidence, Prevalence, Survival Analysis, Coronary Angiography, Myocardial Ischemia, Metabolic Syndrome
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