Metabolic syndrome and left ventricular hypertrophy in the prediction of cardiovascular events: The Strong Heart Study
Received 9 January 2008; received in revised form 6 April 2008; accepted 7 April 2008. published online 01 August 2008.
Refers to corrigendum:
Corrigendum to “Metabolic syndrome and left ventricular hypertrophy in the prediction of cardiovascular events: The Strong Heart Study” [Nutr Metab Cardiovasc Dis 19 (2009) 98–104]
, 08 June 2009
G. de Simone, R.B. Devereux, M. Chinali, M.J. Roman, E.T. Lee, H.E. Resnick, B.V. Howard
Nutrition, Metabolism & Cardiovascular Diseases
September 2009 (Vol. 19, Issue 7, Page 520) Full Text |
Full-Text PDF (73 KB)
Abstract
Background and aims
Metabolic syndrome (MetS) is associated with increased prevalence of echocardiographic LV hypertrophy (LVH), a potent predictor of cardiovascular (CV) outcome. Whether MetS increases risk of CV events independently of presence of LVH has never been investigated. It is also unclear whether LVH predicts CV risk both in the presence and absence of MetS.
Methods and results
Participants in the 2nd Strong Heart Study examination without prevalent coronary heart disease, congestive heart failure or renal insufficiency (plasma creatinine >2.5mg/dL) were studied (n=2758; 1746 women). MetS was defined by WHO criteria. Echocardiographic LV hypertrophy was defined using population-specific cut-point value for LV mass index (>47.3g/m2.7). After controlling for age, sex, LDL-cholesterol, smoking, plasma creatinine, diabetes, hypertension and obesity, participants with MetS had greater probability of LVH than those without MetS (OR=1.55 [1.18–2.04], p<0.002). Adjusted hazard of composite fatal and non-fatal CV events was greater when LVH was present, in participants without (HR=2.03 [1.33–3.08]) or with MetS (HR=1.64 [1.31–2.04], both p<0.0001), with similar adjusted population attributable risk (12% and 14%). After adjustment for LVH, risk of incident CV events remained 1.47-fold greater in MetS (p<0.003), an effect, however, that was not confirmed when diabetic participants were excluded.
Conclusion
LVH is a strong predictor of composite 8-year fatal and non-fatal CV events either in the presence or in the absence of MetS and accounts for a substantial portion of the high CV risk associated with MetS.
Corresponding author: Department of Clinical and Experimental Medicine, Federico II University Hospital, v.S.Pansini 5, 80131 Naples, Italy. Tel.: +39 081 746 2013.
ABSTRACT