CORONARY ATHEROSCLEROSIS STAGING IN PATIENTS DIAGNOSED BY DIFFERENT DEFINITION OF METABOLIC SYNDROME

Background and Aims: Metabolic Syndrome (MS) is associated to an increased rate of CHD in general population. However it is not yet clear which current definition of MS is more useful to screen patients with a higher risk to have worse atheromasic coronary lesions. Our aim was to evaluate if different MS definitions are able to differently detect patients with more serious coronary lesions. Methods: We consecutively enrolled 184 patients (M:63.6%, W:36.4%; Mean age: 57,9±10,4 years) with symptoms usually related to reduced coronary reserve. We classified the coronary lesions as “minimal” or “serious” on the basis of the indication of revascularization. The patient were then classified as MS affected or not on the basis of the WHO, ATP III, and IDF suggested criteria. Results: The WHO MS definition included the 64% of serious patients, The ATP III MS definition the 63%, and the IDF MS definition the 72%. Parameters significantly associated to the worse coronary lesions were the Waist-Hip ratio (OR 5.3, 95%CI 1.7-11.6) and the diagnosis of diabetes (OR 8.1, 95%CI 1.2-15.2). No one of the components of the MS appeared to be significantly associated to the worse lesions in any of the applied MS definitions. Conclusion: the IDF definition of MS appears to include a larger quantity of patients with worse coronary lesions that the WHO and ATP III ones. However it is not clear if it is the simple effect of unspecific cut-off applications to high-risk subjects or if it could have a concrete pathogenetic basis.