Influence of Metabolic Syndrome on Plaque Features and Clinical Outcomes in Patients with Acute Coronary Syndrome

Overview

Journal Clin Res Cardiol

Specialty Cardiology & Vascular Diseases

Date 2024 Sep 19

PMID 39297939

Authors

Hanzhi Wu

Yanwei Yin

Fangmeng Lei

Xiaoxue Ma

Wenlin Lu

Yanqing Shen

Lizhu Zhang

Xiaoxiao Liu

Wenjing Hu

Xinhe Ye

Chengjian Yang

Affiliations

Soon will be listed here.

Abstract

Background And Aims: Currently, the influence of metabolic syndrome (Mets) on the plaque characteristics and prognosis of patients with acute coronary syndrome (ACS) is poorly understood. Thus, the study aimed to characterize the pancoronay plaques of ACS patients with Mets using optical coherence tomography (OCT) and to evaluate the cohort's prognosis.

Methods: Between February 2015 and September 2020, 745 ACS patients who underwent OCT imaging of the three coronary arteries were included, divided into Mets (n = 252) and non-Mets (n = 493) groups. The major adverse cardiovascular event (MACE) was a composite of cardiac death, non-fatal myocardial infarction (MI), and revascularization.

Results: Compared to the non-Mets group, the Mets group exhibited a higher proportion of females and cases of multivessel disease. In the Mets group, culprit lesions were found to have a greater degree of stenosis, thinner fibrous cap thickness and more thin-cap fibroatheroma (TCFA). Additionally, nonculprit lesions were more likely to exhibit plaque rupture, high-risk plaque characteristics, TCFA, macrophage infiltration, cholesterol crystals, and layered plaque. After a median follow-up of 2 years, 8.3% of patients experienced MACE, a rate that was higher in the Mets group, primarily attributed to non-fatal myocardial infarction and cardiac death. Multivariate analysis showed that Mets (aHR 1.73, p = 0.037), high-risk plaque (aHR 2.63, p < 0.001), age (aHR 1.03, p = 0.020), and left ventricular ejection fraction (aHR 0.96, p = 0.002) were independent predictors of MACE.

Conclusions: The presence of Mets increased the vulnerability of the entire coronary tree and worsened the prognosis for patients with ACS.

Citing Articles

Etiology, Pathophysiology, and Treatment Strategies in the Prevention and Management of Metabolic Syndrome.

Patial R, Batta I, Thakur M, Sobti R, Agrawal D Arch Intern Med Res. 2024; 7(4):273-283.

PMID: 39574946 PMC: 11580789. DOI: 10.26502/aimr.0184.

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