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Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Metabolic syndrome and its components reduce coronary collateralization in chronic total occlusion: An observational
Tong Liu1, Zheng Wu1, Jinghua Liu2
1Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, No. 2 Anzhen Street, Chaoyang District, Beijing, 100029, China.
Insights
Metabolic syndrome (MetS) and its components, particularly body mass index, are linked to poorer coronary collateralization (CC) in patients with chronic total occlusion (CTO). Higher MetS severity correlates with reduced CC, highlighting its role in cardiovascular disease risk.
Area of Science:
- Cardiology
- Metabolic Diseases
- Vascular Biology
Background:
- Metabolic syndrome (MetS) is a significant independent risk factor for cardiovascular diseases.
- Chronic total occlusion (CTO) presents challenges in cardiovascular interventions.
- The relationship between MetS and coronary collateralization (CC) in CTO is not fully understood.
Purpose of the Study:
- To investigate the association between MetS and its components with CC in patients with CTO.
- To determine the extent to which MetS influences the development of coronary collateralization.
Main Methods:
- A study of 1653 inpatients with CTO.
- Data collection included demographic and clinical characteristics.
- Coronary collateralization was assessed using the Rentrop scoring system.
- Statistical analyses included subgroup analysis, mixed model regression, and ROC curve analysis.
Main Results:
- The incidence of MetS was higher in patients with poor CC compared to those with good CC.
- Poor collateralization increased progressively with the number of MetS diagnostic criteria met.
- Body Mass Index (BMI) was consistently identified as a risk factor for CC growth across all patient groups.
- MetS was confirmed as an independent risk factor for CC growth in several regression models.
Conclusions:
- Metabolic syndrome, especially elevated BMI, significantly increases the risk of poor coronary collateralization in CTO patients.
- The findings suggest that MetS negatively impacts the development of collateral circulation in the context of CTO.
- Further research into scoring systems for MetS in CTO patients is warranted to improve risk stratification and management.
Background:
Metabolic syndrome (MetS) is an independent risk factor for the incidence of cardiovascular diseases. We investigated whether or to what extent MetS and its components was associated with coronary collateralization (CC) in chronic total occlusion (CTO).
Methods:
This study involved 1653 inpatients with CTO. Data on demographic and clinical characteristics were collected by cardiovascular doctors. The CC condition was defined by the Rentrop scoring system. Subgroup analysis, mixed model regression analysis, scoring systems and receiver operating characteristic (ROC) curve analysis were performed.
Results:
Overall, 1653 inpatients were assigned to the poor CC group (n = 355) and good CC group (n = 1298) with or without MetS. Compared to the good CCs, the incidence of MetS was higher among the poor CCs for all patients. Poor collateralization was present in 7.6%, 14.2%, 19.3%, 18.2%, 35.6% and 51.1% of the six groups who met the diagnostic criteria of MetS 0, 1, 2, 3, 4 and 5 times, respectively. For multivariable logistic regression, quartiles of BMI remained the risk factors for CC growth in all subgroups (adjusted OR = 1.755, 95% CI 1.510-2.038, P < 0.001 all patients; adjusted OR = 1.897, 95% CI 1.458-2.467, P < 0.001 non-MetS; and adjusted OR = 1.814, 95% CI 1.482-2.220, P < 0.001 MetS). After adjustment for potential confounding factors, MetS was an independent risk factor for CC growth in several models. Assigning a score of one for each component, the AUCs were 0.629 (95% CI 0.595-0.662) in all patients, 0.656 (95% CI 0.614-0.699) in MetS patients and 0.569 (95% CI 0.517-0.621) in non-MetS patients by receiver operating characteristic analysis.
Conclusions:
MetS, especially body mass index, confers a greater risk of CC formation in CTO. The value of scoring systems should be explored further for CTO.
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