الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 32 |  |  |
| | | from | 32 | | |
Abstract
A cluster of risk factors for cardiovascular diseases and T2D, which occur together more often than by chance alone, have become known as the metabolic syndrome. The risk factors include raised blood pressure, dyslipidemia (raised triglycerides and lowered high-density lipoprotein cholesterol), raised fasting glucose, and central obesity. Various diagnostic criteria have been proposed by different organizations over the past decade. Most recently, these have come from the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. In addition, it has been demonstrated that individuals with this condition are at a three-fold greater risk of coronary heart disease (CHD) and stroke, and more than a five-fold greater risk of cardiovascular mortality. In addition, MetS has recently been shown to be related to an increased risk of subclinical ischemic heart disease, as determined by resting electrocardiogram criteria.
Assessment of coronary plaque burden has contributed to the understanding of the natural history and pathophysiology of coronary artery disease (CAD) and as a surrogate end point for the evaluation of novel cardiovascular therapeutics. Invasive modalities such as intravascular ultrasound (IVUS) and serial selective coronary angiography are considered gold standard methods to measure progression of atherosclerotic plaque and stenoses over time. However, these modalities are limited by their invasive nature. Recently, MDCT has become a clinically established tool for the diagnosis of significant coronary artery disease(75). In addition, MDCT permits the assessment of complex coronary atherosclerotic plaque morphology, distribution, arterial luminal visualization and composition of the advanced plaques in good agreement with intravascular ultrasound (76).
The aim of this study was to assess the relation between metabolic syndrome and the type of coronary plaques and their components by 64-MDCT in comparison with non-metabolic syndrome subjects.
The study population consisted of 60 subjects presenting with suspected angina pectoris or with low/intermediate pre-test likelihood of CAD (30 patients had MetS, 30 subjects did not fullfill the criteria of MetS) who were screened with 64-MDCT coronary angiographies between July 2012 and July 2013 at ICC (International Cardiac Center) Scan Centre, Alexandria-Egypt.
All patients were subjected to detailed history taking, clinical evaluation, ECG analysis and laboratory investigations assessing lipid profile, fasting blood glucose, blood urea and serum creatinine.
After patient preparation, all coronary arteries screened for segments with atherosclerotic plaques and assessed as regard plaque composition and degree of stenosis.