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Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Metabolic syndrome predicts cardiovascular and all-cause adverse outcomes in patients with chronic inflammatory
Zhuoran Li1, Tingting Zou2, Yadong Li3
1Shanxi Medical University, Taiyuan, 030001, China.
Insights
Metabolic syndrome (MetS) significantly increases cardiovascular and all-cause risks in patients with chronic inflammatory arthritis (CIA). Each additional MetS component further elevates cardiovascular risk, highlighting the importance of managing MetS in this population.
Area of Science:
- Rheumatology
- Cardiology
- Metabolic Diseases
Background:
- Chronic inflammatory arthritis (CIA) is linked to higher cardiovascular risk.
- Metabolic syndrome (MetS) is common in CIA patients and may worsen outcomes.
Purpose of the Study:
- To determine if MetS independently predicts adverse cardiovascular and all-cause events in CIA patients.
- To assess the relationship between the number of MetS components and patient prognosis.
Main Methods:
- Prospective observational study of 811 CIA patients.
- Propensity score matching (PSM) used to balance groups.
- Cox regression and Kaplan-Meier analyses for outcome evaluation.
Main Results:
- MetS was present in 35% of patients.
- Patients with MetS had significantly higher rates of cardiovascular (18.4% vs 7.7%) and all-cause events (37.8% vs 19.9%).
- MetS independently predicted cardiovascular (aHR=4.12) and all-cause outcomes (aHR=2.81). Each additional MetS component increased cardiovascular risk by 1.68-fold.
Conclusions:
- MetS is an independent risk factor for adverse cardiovascular and all-cause outcomes in CIA patients.
- A dose-response relationship exists: more MetS components lead to higher cardiovascular risk.
Objectives:
Chronic inflammatory arthritis (CIA), including rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS), is associated with elevated cardiovascular risk. Metabolic syndrome (MetS) is prevalent among these patients and may contribute to adverse clinical outcomes. This study aimed to investigate whether MetS independently predicts cardiovascular and all-cause adverse events in patients with CIA and to evaluate the dose-response relationship between the number of MetS components and prognosis.
Method:
In this prospective observational study, 811 patients with CIA were enrolled between January 2016 and December 2020. Propensity score matching (PSM) was used to balance baseline covariates between patients with and without MetS. Primary and secondary endpoints were composite cardiovascular death/hospitalization and all-cause death/hospitalization, respectively. Cox proportional hazards regression models and Kaplan-Meier survival analyses were employed to evaluate the associations between MetS status and study outcomes.
Results:
MetS was present in 35.0% of patients. During a median follow-up of 39 months, cardiovascular events occurred significantly more frequently in patients with MetS compared to those without (18.4% vs. 7.7%, p = 0.002). All-cause events were also higher in the MetS group (37.8% vs. 19.9%, p < 0.001). MetS independently predicted cardiovascular (adjusted HR = 4.12, 95% CI: 2.11-8.07, p < 0.001) and all-cause outcomes (adjusted HR = 2.81, 95% CI: 1.79-4.41, p < 0.001). Each additional MetS component was associated with a 1.68-fold increased risk of cardiovascular outcomes (95% CI: 1.24-2.51, p < 0.001).
Conclusions:
MetS is an independent risk factor for cardiovascular and all-cause adverse outcomes in patients with CIA. Key Points • MetS independently predicts both cardiovascular and all-cause adverse outcomes in patients with CIA after propensity score matching. • A dose-response relationship was identified, with each additional MetS component conferring higher cardiovascular risk.
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