الفهرس 
IntroductionOnly 14 pages are availabe for public view
Abstract
The metabolic syndrome is characterized by a clustering of cardiovascular risk factors including hyperglycemia, obesity, dyslipidemia, and hypertension. However, the relative contribution of specific metabolic syndrome components in the prediction of coronary artery disease severity remains under debate. In addition, the interactions of these cardiovascular risk factors and gender are even less clarified.
The objectives of this study were to clarify the effect of the individual components of metabolic syndrome on the severity and extent of coronary artery disease by means of coronary angiography, to determine the prevalence of severe coronary artery disease in metabolic syndrome patients, and to compare the gender effect on the severity of coronary artery disease in those patients.
The study included 120 patients fulfilling the IDF criteria of metabolic syndrome diagnosis who were scheduled for elective coronary angiography or PCI at the cardiology department of Suez Canal University hospital because of suspected or established CAD.
The results of the present study showed that hypertension and low HDL-C were the only significant predictive factors for the presence of angiographic coronary artery disease in metabolic syndrome patients; odds ratio=13.532 (95% CI 1.244147.223) and 0.168 (95% CI 0.0500.561), p-value = 0.032, 0.004 for hypertension and low HDL-C respectively.
Vessel score was significantly correlated to the following components of metabolic syndrome: presence of diabetes mellitus or high fasting blood glucose (r =0.76, p-value = 0.03), hypertriglyceridemia (r =0.23, p-value = 0.01) and the low HDL-C (r =0.33, p-value = 0.000). Also, hypertension, presence of diabetes mellitus or impaired fasting glucose and low HDL-c levels were significant independent predictors of the vessel score.
Gensini score was significantly correlated to presence of hypertension (r =0.106, p-value = 0.025) and the low levels of HDL-C (r =0.251, p-value = 0.006). Moreover, hypertension and low HDL levels were significant independent predictors of the Gensini score. (p-value = 0.010 and 0.012 respectively)
Extent score was significantly correlated to hypertension (r =0.26, p-value = 0.004) and hypertriglyceridemia (r =0.207, p-value = 0.023). However, hypertension was the only significant independent predictor of the extent score.
Severity of coronary artery disease as expressed by vessel, Gensini and extent scores, was significantly correlated with the increasing number of metabolic syndrome components (r= 0.374, 0.342 and 0.379; p-value= 0.000, 0.000 and 0.000 respectively).
This study showed that 80.8% of the study population had significantly angiographic CAD, with higher prevalence among males (95.1%) versus (66.1%) among females.
This study showed that CAD severity and extent were higher in males rather than females. Prevalence of two and multi-vessel diseases was higher in males rather than females. Males were found to have higher severity (Gensini) score than females. Also, males had higher Extent Score than females. Moreover, classification of the CAD angiographic severity by tertile portioning of Gensini score revealed that high Gensini score was reported in 30.8% of the study population while low and mid Gensini scores were reported in 15% and 35% of the study population respectively. High Gensini score was reported in 39.3% of males and 22% in females.
In conclusion, in this study population of Egyptian patients, the individual components of metabolic syndrome and their various combinations had different values in respect of risk prediction of CAD and the severity of coronary artery stenosis. Hypertension and low HDL-C were the only predictive factors for the presence of significantly angiographic coronary artery disease. Moreover, hypertension, diabetes mellitus or high fasting blood glucose and low HDL-C were significant independent predictors of the various CAD severity scores. Also, gender difference was evident regarding the different values and correlations of metabolic syndrome components and CAD severity scores, and in the higher burden of CAD among male population.