Metabolic syndrome and coronary angiographic disease progression: The Women's Angiographic Vitamin & Estrogen trial
Metabolic syndrome and coronary angiographic disease progression: The Women's Angiographic Vitamin & Estrogen trial
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DOI：
10.1016/s0002-8703(03)00227-8
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发表时间：
2003-09-01
影响因子：
4.8
通讯作者：
Howard, BV
中科院分区：
文献类型：
--
作者：
Hsia, J;Bittner, V;Howard, BV
背景代谢综合征是一组被认为与冠心病风险增加相关的临床特征。该分析评估了参加妇女血管造影维生素和雌激素（WAVE）试验的绝经后妇女的冠状动脉疾病的血管造影进展，方法1997年7月至1998年8月，在7家诊所共纳入425名绝经后并有冠状动脉造影的妇女1999.当女性符合国家胆固醇教育计划成人治疗组III的定义时，她们被归类为患有代谢综合征。在基线和2.8 +/- 0.9年（平均值+/- SD）后进行冠状动脉造影。结果代谢综合征女性患者（177/294，60%）更有可能服用降胆固醇药物（65%vs51%，P = 0.01），并且有更高的体重指数（33 +/-6vs28 +/-6kg/m2，P <0.001）。代谢综合征女性患者的最小管腔直径平均减少更大（-0.041 +/- 0.151 vs -0.023 +/- 0.148 mm/年，P = 0.33），新发病变更常见（34% vs 23%，P = 0.054）。在多变量分析中，代谢综合征不是血管造影疾病进展的独立预测因子。然而，临床事件（心肌梗死，中风，或冠状动脉死亡）更频繁的妇女与代谢综合征（P = 0.02）。结论代谢综合征是流行的绝经后妇女与冠状动脉疾病入组的WAVE试验。患有代谢综合征与最小管腔直径的变化或新的或进展性冠状动脉病变的发展无关，但确实增加了临床心血管事件的风险。
Background The metabolic syndrome is a cluster of clinical characteristics thought to be associated with increased coronary risk. This analysis evaluates angiographic progression of coronary disease in women who are postmenopausal with and without the metabolic syndrome enrolled in the Women's Angiographic Vitamin & Estrogen (WAVE) trial, a randomized, controlled trial of hormone therapy and antioxidant vitamins.Methods A total of 425 women who are postmenopausal and have angiographic coronary disease were enrolled at 7 clinics between July 1997 and August 1999. Women were categorized as having the metabolic syndrome when they met the National Cholesterol Education Program Adult Treatment Panel III definition. Coronary angiograms were performed at baseline and after 2.8 +/- 0.9 years (mean +/- SD). Quantitative coronary angiographic analysis was performed at a core laboratory.Results Women with the metabolic syndrome (177/294, 60%) were more likely to be taking cholesterol-lowering medication (65% vs 51%, P = .01) and had higher body mass index (33 +/- 6 vs 28 +/- 6 kg/m(2), P < .001). The mean reduction in minimum lumen diameter was greater (-0.041 +/- 0.151 vs -0.023 +/- 0.148 mm/year, P = .33) and new lesions were more frequent (34% vs 23%, P = .054) in women with the metabolic syndrome. In multivariate analysis, the metabolic syndrome was not an independent predictor of angiographic disease progression. However, clinical events (myocardial infarction, stroke, or coronary death) were more frequent among women with the metabolic syndrome (P = .02).Conclusion The metabolic syndrome was prevalent among postmenopausal women with coronary disease enrolled in the WAVE trial. Having the metabolic syndrome was not independently associated with changes in minimum lumen diameter or the development of new or progressing coronary lesions, but did confer an increased risk of clinical cardiovascular events.