Association of Metabolic Syndrome with Severity of Coronary Artery Disease in Patients Undergoing Coronary Angiography with the Gensini Sore: A Cross-Sectional Observational Study
DOI:
https://doi.org/10.21276/1r4yk964Keywords:
coronary artery disease, coronary angiography, insulin resistance, metabolic syndromeAbstract
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.
Downloads
References
Vaidya D, Szklo M, Liu K, Schreiner PJ, Bertoni AG, Ouyang P. Defi ning the metabolic syndrome construct: Multi-Ethnic Study of Atherosclerosis (MESA) cross-sectional analysis. Diabetes Care 2007;30:2086–2090.
Xu JJ, Song Y, Jiang P, Jiang L, Zhao XY, Gao Z, Li JX, Qiao SB, Gao RL, Yang YJ, et al. Ef ects of metabolic syndrome on onset age and long-term outcomes in patients with acute coronary syndrome. World J Emerg Med. 2021;12:36–41
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486 97
Şendur MAN, Güven GS. Current Overview of Metabolic Syndrome. Journal of Internal Medicine. 2011;18:125–131.
Gui MH, Ling Y, Liu L, Jiang JJ, Li XY, Gao X. Effect of metabolic syndrome score, metabolic syndrome, and its individual components on the prevalence and severity of angiographic coronary artery disease. Chinese medical journal. 2017 Mar 20;130(6):669.
Chandrashekar K, Hasabi IS, Mamdapur M., et al. A study of metabolic syndrome in patients undergoing coronary angiography at KIMS Hospital, Hubballi, Karnataka, India. J. Evid. Based Med. Healthc. 2018; 5(2), 169- 176
Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. The lancet. 2005 Apr 16;365(9468):1415-28.
Isomaa BO, Almgren P, Tuomi T, Forsén B, Lahti K, Nissén M, Taskinen MR, Groop L. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes care. 2001 Apr 1;24(4):683-9.
Alberti G, Zimmet P, Shaw J, Grundy SM. The IDF consensus worldwide definition of the metabolic syndrome. Brussels: International Diabetes Federation. 2006 Nov 8;23(5):469-80.
Dobblesteyn CJ, Joffres MR, MacLean DR, Flowerdew G. A comparative evaluation of waist circumference, waist to hip ration and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Survays. Int J Obesity 2001; 25: 652-661.
Nelwan SP, Kors JA, Meij SH, van Bemmel JH, Simoons ML. Reconstruction of the 12-lead electrocardiogram from reduced lead sets. Journal of electrocardiology. 2004 Jan 1;37(1):11-8.
Trinder P. Determination of glucose in blood using glucose oxidase with an alternative oxygen acceptor. Annals of clinical Biochemistry. 1969 Jan;6(1):24-7.
Allain CC, Poon LS, Chan CS, Richmond WF, Fu PC. Enzymatic determination of total serum cholesterol. Clinical chemistry. 1974 Apr 1;20(4):470-5.
Chen ZW, Chen YH, Qian JY, Ma JY, Ge JB. Validation of a novel clinical prediction score for severe coronary artery diseases before elective coronary angiography. PLoS One. 2014 Apr 8;9(4):e94493.
Piuri G, Zocchi M, Della Porta M, Ficara V, Manoni M, Zuccotti GV, Pinotti L, Maier JA, Cazzola R. Magnesium in obesity, metabolic syndrome, and Type 2 diabetes. Nutrients. 2021;13:320
World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1, Diagnosis and classification of diabetes mellitus. World Health Organization; 1999.
Zeller M, Steg PG, Ravisy J, Laurent Y, Janin-Manificat L, L'Huillier I, Beer JC, Oudot A, Rioufol G, Makki H, Farnier M. Prevalence and impact of metabolic syndrome on hospital outcomes in acute myocardial infarction. Archives of internal medicine. 2005 May 23;165(10):1192-8.
Harding SA, Anscombe R, Weatherall M, Prasad S, Lever N, Krebs J. Abnormal glucose metabolism and features of the metabolic syndrome are common in patients presenting for elective cardiac catheterization. Intern Med J 2006;36:759–764.
Konstantinou DM, Chatzizisis YS, Louridas GE, Giannoglou GD. Metabolic syndrome and angiographic coronary artery disease prevalence in association with the Framingham risk score. Metabolic syndrome and related disorders. 2010 Jun 1;8(3):201-8.
Anuurad E, Chiem A, Pearson TA, Berglund L. Metabolic syndrome components in African-Americans and EuropeanAmerican patients and its relation to coronary artery disease. Am J Cardiol 2007;100:830–834.
Khanna R, Kapoor A, Kumar S, Tewari S, Garg N, Goel PK. Metabolic syndrome & Framingham Risk Score: observations from a coronary angiographic study in Indian patients. The Indian journal of medical research. 2013 Feb;137(2):295.
Hassanin N, Gharib S, El Ramly MZ, Meged MA, Makram A. Metabolic syndrome and coronary artery disease in young Egyptians presenting with acute coronary syndrome. Kasr Al Ainy Medical Journal. 2015 Jan 1;21(1):27.
Afsana F, Latif ZA, Haq MM. Parameters of metabolic syndrome are markers of coronary heart disease–An observational study. International Journal of Diabetes Mellitus. 2010 Aug 1;2(2):83-7.
Mahalle N, Garg MK, Naik SS, Kulkarni MV. Association of metabolic syndrome with severity of coronary artery disease. Indian journal of endocrinology and metabolism. 2014 Sep;18(5):708.
Sukhija R, Fahdi I, Garza L, Fink L, Scott M, Aude W, Pacheco R, Bursac Z, Grant A, Mehta JL. Inflammatory markers, angiographic severity of coronary artery disease, and patient outcome. The American journal of cardiology. 2007 Apr 1;99(7):879-84.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 International Archives of BioMedical and Clinical Research (IABCR)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
