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Relationship Between Framingham Risk Score And Metabolic Syndrome For Predicting Coronary Artery Disease
J. Lander, N. Coplan, D. Hersh, S. Ayyanathan, G. Panagaopoulos, H. Levitt, S. Toor, M. Jimenez, R. Schaller, S. Patel, Cardiology, Lenox Hill Hospital, New York, NY

Purpose of Study: The Framingham Risk Score estimates patientsí risk of cardiovascular events. The metabolic syndrome (MetS) has been shown to increase patientsí risk of cardiovascular events. The purpose of this study was to examine how the presence of metabolic syndrome influences the presence of obstructive coronary artery disease (CAD) at different Framingham risk levels.

Methods Used: This study included 1000 patients with no history of CAD who presented for elective cardiac catheterization. The study group had a mean age of 62.6 +/- 11 years, and was comprised of 571 men and 429 women. Patients were evaluated for MetS using the NCEP-ATP III criteria. Framingham risk groups were divided into tertiles (0-10%; 11-20%; >20% risk). Significant CAD was defined as the presence of at least 70% in a major coronary vessel and/or 50% stenosis in the left main coronary artery.

Summary of Results: CAD was present in 451 patients, and MetS was present in 486 patients. Patients with MetS were significantly more likely to have CAD than patients without MetS (51.4% vs 43%, p<.01). Increasing Framingham risk tertiles were significantly more likely to have CAD (35.5% vs 58.4% vs 71.6%, p<.01 for each comparison). Results from evaluating the effect of MetS on CAD at different tertiles of Framingham risk are revealed in the table below.

Multivariate analysis showed that the Framingham Score is a significant predictor of CAD; the addition of MetS does not add to CAD prediction, and there is no significant interaction noted.

Conclusions: Assessing MetS does not effect the incidence of obstructive CAD at any Framingham Risk level.

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