Open AccessImpaired Fasting Glucose Is the Major Determinant of the 20‐Year Mortality Risk Associated With Metabolic Syndrome in Nondiabetic Patients With Stable Coronary Artery Disease
Author(s) -
Younis Arwa,
Goldkorn Ronen,
Goldenberg Ilan,
Geva Diklah,
Tzur Boaz,
Mazu Anna,
Younis Anan,
Fisman Zvi,
Tannenbaum Alexander,
Klempfner Robert
Publication year - 2017
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.117.006609
Subject(s) - medicine , hazard ratio , impaired fasting glucose , confidence interval , metabolic syndrome , coronary artery disease , proportional hazards model , cardiology , myocardial infarction , impaired glucose tolerance , obesity , insulin resistance
Background We wanted to explore the association of metabolic syndrome (MetS) versus its individual components with 20‐year all‐cause mortality among patients with stable coronary artery disease. Methods and Results The cohort comprised 12 403 nondiabetic patients with stable coronary artery disease who were enrolled in the Bezafibrate Infarction Prevention Registry between February 1990 and October 1992 and followed up through December 2014. The study cohort was divided into 4 groups: patients without MetS or impaired fasting glucose ( IFG ), patients with IFG but without MetS, patients with MetS but without IFG , and patients with both MetS and IFG . Kaplan‐Meier survival analysis showed that at 20 years of follow‐up, the rates of all‐cause mortality were the highest among patients with both MetS and IFG (66%). Patients with IFG without MetS experienced a significantly higher mortality rate compared with those with MetS without IFG (61% versus 56%; log‐rank P <0.001). Multivariable Cox proportional hazard analysis showed that the final Cox model demonstrated that the additive effect of MetS (hazard ratio, 1.13; 95% confidence interval, 1.1–1.16; P =0.02) and IFG (hazard ratio, 1.54; 95% confidence interval, 1.46–1.62; P <0.001) on 20 years mortality was nonsignificant (hazard ratio, 1.01; 95% confidence interval, 0.93–1.11; P =0.69). IFG was associated with the most pronounced increase in mortality risk among the individual components (hazard ratio, 1.22; 95% confidence interval, 1.14–1.3; P <0.001). Conclusions Our findings suggest that IFG alone is a major independent predictor of long‐term mortality among patients with stable coronary artery disease versus other components of the MetS.