Association of Metabolic Syndrome with Severity of Coronary Artery Disease in Patients Undergoing Coronary Angiography with the Gensini Sore: A Cross-Sectional Observational Study
Background: Little data exists about the association of metabolic syndrome (MetS) with severity of coronary artery disease (CAD) and correlation of the extent of CAD in patients with MetS assessed by Gensini score in Indian context.
Aim: The present study explored to investigate the association of MetS and its metabolic components with severity of CAD in patients undergoing coronary angiography and to compare the severity of CAD in patients with MetS and without MetS using the Gensini score.
Methods: This was a single-center, observational and cross-sectional study conducted at tertiary health care center between July, 2020 and June, 2021. The study population included 100 consecutive patients who underwent coronary angiography and were divided into two groups based on International Diabetes Federation (IDF) criteria (1): Group I (n=56 patients with MetS) and Group II (n=44 patients without MetS).
Results: Prevalence of MetS in CAD was found in 42 patients. A higher prevalence of male patients was found in both the groups (55.4% vs. 68.2%, p=0.272) with a mean age of 55.32 ± 7.8 and 53.45 ± 10.4 years, respectively (p=0.308). Body mass index (26.80 ± 2.80 kg/m2 vs. 24.08 ± 1.87 kg/m2; p<0.001), BMI>25 kg/m2 (71.43% vs. 38.64%; p<0.001), waist/hip ratio (0.93 ± 0.02 vs. 0.91 ± 0.02; p <0.001), and hypertension (60.71% vs. 20.45%; p <0.001) were the most common risk factors found significantly higher in group I than group II. All the components of MetS according to IDF criteria were significantly higher in group I compared to group II (p<0.005), except triglycerides (p=0.285). Fasting blood glucose was the most common component of MetS followed by SBP, DBP and HDL. Significant correlation was found between number of vessels affected and Gensini score (p<0.01) as well as between sex and Gensini score (p<0.001). Group I had significant higher values of hypertension (44.47 ± 41.33 vs. 29.16 ± 22.47; p=0.020), alcohol consumption (46.71 ± 36.66 vs. 31.26 ± 30.05; p=0.031), and xanthelesma (69.25 ± 35.78 vs. 32.83 ± 30.93; p=0.002) than group II. Low levels of HDL correlated significantly with the Gensini score (p<0.001).
Conclusion: Patients with CAD had a higher prevalence of metabolic syndrome thus it is associated with severity of CAD. Gensini score may be employed to recognize patients at a high risk for CAD.
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