Metabolic syndrome in the prediction of cardiovascular events: the potential additive role of hsCRP and adiponectin

Objective: About 90% of cardiovascular diseases can be prevented. In recent years, the role of vitamin D in the prevention of cardiovascular disease and components of metabolic syndrome has been actively discussed. The study aimed to investigate the possible influence of vitamin D3 on the emergence risk of metabolic syndrome and adverse cardiovascular events. Materials and methods: The study enrolled a total of 336 people (170 males and 166 females) aged 50-60 years. For comparative analysis, two groups were formed: Group 1 group involved 150 people treated with placebo, and Group 2 group included 186 people who received vitamin D3 orally in a dose of 2000 IU/day. The duration of treatment and observation was four years. Participants in the study completed a questionnaire developed by the authors of this paper, in which they answered questions about the presence of factors contributing to the development of cardiovascular pathology. Results and Discussion: Daily oral intake of vitamin D3 in a dose of 2000 IU/day for four years did not improve laboratory indicators, which are components of MS, namely, the content in the blood of TC, TG, LDL, HDL, AI, fasting and postprandial glycemia, insulin, and insulin resistance index HOMA2-IR (p>0.05). Prolonged use of vitamin D3 did not reduce the risk of cardiovascular diseases (myocardial infarcts (RR=0.93, 95% CI [0.21-4.09], p=0.92), strokes (RR=1.24, 95% CI [0.18-8.70], p=0.83), stenting (RR=1,23, 95% CI [0.32-4.88], p=0.76), arterial hypertension (RR=1.12, 95% CI [0.47-2.68], p=0.81), as well as cardiovascular death rates (RR=0.83, 95% CI [0.14-4.88], p=0.83) and death from any other causes (RR=0.93, 95% CI [0.21- 4.09], p=0.92). Conclusion: Thus, daily prolonged oral administration of vitamin D3 in a dose of 2000 IU/day does not contribute to the improvement of blood lipid spectrum, glycemia, and insulin resistance in metabolic syndrome and does not reduce the risk of adverse (fatal and non-fatal) cardiovascular events. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.431-438

Download Full-text

The role of osteoprotegerin as a predictor of cardiovascular events in patients with metabolic syndrome and diabetes mellitus (review)

Актуальные проблемы медицины ◽

10.52575/2687-0940-2021-44-1-57-67 ◽

2021 ◽

Vol 44 (1) ◽

pp. 57-67

Author(s):

Tatyana P. Golivets ◽

Diana O. Gagarina ◽

Diana G. Dubonosova ◽

Sergey V. Likrizon

Keyword(s):

Diabetes Mellitus ◽

Metabolic Syndrome ◽

Cardiovascular Events

Download Full-text

The significant role of coronary artery calcification score in asymptomatic patients with metabolic syndrome

European Heart Journal ◽

10.1093/eurheartj/ehab724.2642 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

M Temtem ◽

M Serrao ◽

M I Mendonca ◽

M Santos ◽

J A Sousa ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Coronary Heart Disease ◽

Logistic Regression ◽

Heart Disease ◽

Cardiovascular Risk ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Cardiovascular Events

Abstract Background Metabolic syndrome (MetS) is a clinical condition composed of metabolic and cardiovascular risk factors, such as abdominal obesity, hyperglycemia, dyslipidemia and hypertension. Many patients with MetS suffer major adverse cardiovascular events (MACE) that are not adequately identified by traditional risk assessment, suggesting the need for early detection of subclinical coronary heart disease to identify those at high-risk. Coronary artery calcification (CAC) screening has added utility in categorizing patients with low, intermediate and high cardiovascular risk. Purpose Evaluate the prognostic role of CAC score in asymptomatic population patients with metabolic syndrome in cardiovascular events risk prediction. Methods A total of 1,122 asymptomatic individuals without known coronary heart disease, enrolled from GENEMACOR study, were followed for a mean of 5.3±3.4 years for the primary endpoint of all-cause of cardiovascular events. All were referred for computed tomography for the CAC scoring assessment. According to the Hoff's nomogram, 3 categories were created: low CAC (0≤CAC<100 or P<50); moderate CAC (100≤CAC<400 or P50–75) and high or severe CAC (CAC≥400 or P>75). In a subgroup of 507 individuals with MetS and 615 controls, CAC values were compared by T-student and association of CAC severity with events occurrence was evaluated. Finally, a logistic regression model adjusted for CAC severity was performed in patients with MetS. Results Among our population, the extent of CAC differs significantly between men and women in the same age group. Patients with Mets (23.2%, n=115) had higher CAC scores than controls (219.0±486.0 vs 115.8±370.8, p<0.0001). In this cohort, with higher CAC scores, 46.7% vs 22.5% had MACEs (p=0.049) during the follow-up. The logistic regression analysis revealed that CAC≥400 is a MACE predictor (OR=4.326, CI 95% 1.241–15.080, p=0.021) in patients with MetS. Conclusion Our results point to the importance of the inclusion of CAC screening in patients with MetS to further stratify those patients that, despite tight control of cardiovascular risk factors, may benefit from more intensive therapies. This tool is a useful and straightforward method that could have a significant impact on the prognosis of future cardiovascular disease in patients with MetS. FUNDunding Acknowledgement Type of funding sources: None.

Download Full-text

Impact of metabolic syndrome on re-stenosis development: Role of drug-eluting stents

Diabetes and Vascular Disease Research ◽

10.1177/1479164111430336 ◽

2012 ◽

Vol 9 (3) ◽

pp. 177-188 ◽

Cited By ~ 6

Author(s):

SN Goyal ◽

S Bharti ◽

B Krishnamurthy ◽

Y Agrawal ◽

SK Ojha ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Cardiovascular Events ◽

Coronary Intervention ◽

Therapeutic Interventions ◽

Drug Eluting Stents ◽

Dietary Control ◽

Obesity And Diabetes ◽

Drug Eluting

Metabolic syndrome (MetS) is defined as a cluster of numerous cardiovascular risk factors, which encompasses obesity, dyslipidaemia, insulin resistance and hypertension. Patients with MetS are more prone to developing cardiovascular events than other patients. To date, several approaches such as physical exercise, dietary control and invasive and non-invasive therapeutic interventions for dyslipidaemia, hypertension and insulin resistance have been used to manage MetS. However, there is a progressive elevation in the incidence of fatal and non-fatal cardiovascular events due to the increased prevalence of obesity and diabetes. Percutaneous coronary intervention has emerged over the last few years as an effective revascularisation strategy for those with coronary artery disease, in parallel with the development of effective anti-platelet medications and newer drug-eluting stents. In recent years, considerable research efforts have been undertaken to elucidate the pathophysiology of re-stenosis and develop strategies to prevent re-stenosis following percutaneous transluminal coronary angioplasty and stent implantation. Although the rate of stent re-stenosis and target-lesion revascularisation has been reduced, there is little information in the literature on the outcome of MetS in the pathophysiology of re-stenosis. In this review article, we summarise the recent development and progress on re-stenosis and the role of drug-eluting stents, particularly in MetS.

Download Full-text

Role of markers of inflammation and endothelial dysfunction in the prognosis of the development of cardiovascular complications in patients with coronary artery disease and metabolic syndrome after coronary stenting

Kardiologiia ◽

10.18087/cardio.2020.8.n966 ◽

2020 ◽

Vol 60 (8) ◽

pp. 98-105

Author(s):

A. V. Svarovskaya ◽

A. T. Teplyakov ◽

A. M. Gusakova ◽

A. A. Garganeeva

Keyword(s):

Metabolic Syndrome ◽

Endothelial Dysfunction ◽

Roc Curve ◽

Cardiovascular Events ◽

Control Group ◽

Endothelin 1 ◽

Atherosclerosis Progression ◽

Group 2 ◽

Group 1

Aim To study the role of inflammation markers and endothelial dysfunction in predicting the risk of cardiovascular event following a percutaneous coronary intervention (PCI) in patients with ischemic heart disease (IHD) and metabolic syndrome (MS).Materials and methods 80 patients (72 men; median age, 56 (50;63) years) with IHD and PCI were evaluated. Based on the presence of MS according to NCEP-ATP III criteria, patients were divided into two groups, group 1 without MS (n=32) and group 2 with MS (n=48). The control age- and sex-matched group included 15 people without cardiovascular diseases. Serum concentrations of tumor necrosis factor α (TNFα), interleukin 6 (IL-6), IL-10, lipoprotein-associated phospholipase A2 (LP-PLA2), and endothelin 1 were measured by enzyme-linked immunosorbent assay (ELISA). Patients were followed up for 12 months after PCI with evaluation of the incidence of adverse cardiovascular events. Statistical analysis was performed with Statistica 10.0 and Medcalc 19.2.6 software. Differences between variables were considered statistically significant at р<0.05. Potential predictors were determined by the ROC analysis with construction of ROC curves, calculation of AUC (area under the curve), identification of COP (cut-off point by the Youden’s index), and sensitivity (Se) and specificity corresponding to the COP.Results Patients with MS had statistically significantly higher serum levels of inflammatory markers than patients of the control group. Concentration of the intravascular inflammation marker, PL-PLA2, was 2.7 times higher in group 1 and 5.1 times higher in group 2 than in the control group (р<0.001). Concentrations of endothelin 1 were 1.9 times higher in group 1 and 3.7 times higher in the MS group compared to the control. At one year after PCI, the incidence of adverse outcomes in the form of cardiovascular events was higher for patients with MS: 10 (20.8 %) cases of stent restenosis and 13 (27.1 %) episodes of coronary atherosclerosis progression according to results of repeated coronarography vs. 2 (6.3%) restenosis cases (χ2–10.853; р=0.002) and 2 (6.3%) episodes of atherosclerosis progression (χ2–23.651; р=0.001) for patients without MS. The groups did not differ in rates of myocardial infarction and cardiac death. The most significant predictors of unfavorable prognosis were LP-PLA2 concentration >983.83 ng/ml (area under the ROC curve, 0.867; sensitivity, 80 %; specificity, 100%; р<0.001) and endothelin 1 overexpression >0.852 fmol/ml (area under the ROC curve, 0.885; sensitivity, 85.5 %; specificity, 83.6 %; р<0.001).Conclusion Patients with MS were characterized by more pronounced imbalance of pro- and anti-inflammatory factors. Concentrations of LP-PLA2 >983.83 ng/ml and endothelin 1 >0.852 fmol/ml were shown to be predictors of unfavorable prognosis for patients with IHD and MS after PCI with coronary stenting.

Download Full-text