ABSTRACT
Background: The relationship between metabolic syndrome score and coronary artery disease severity is unclear in the presence of diabetes. Hypothesis: The hypothesis of this study is to assess whether there is a relationship between metabolic syndrome score and coronary artery disease angiographic severity and whether or not the severity of the relationship differs in the presence of diabetes. Methods: We consecutively enrolled 132 metabolic syndrome patients who underwent their first coronary angiography. We used four angiographic scores and compared the relationship between metabolic syndrome score and angiographic coronary artery disease severity or clinical presentation between diabetic and non-diabetic subjects. Results: Individuals with both metabolic syndrome and diabetes (n=64) had significantly higher metabolic syndrome scores, acute coronary syndromes, double and triple vessel disease, higher coronary score, extent score, severity score, and atherosclerotic score than metabolic syndrome patients without diabetes (n=68). A significant correlation was apparent between metabolic syndrome and coronary atherosclerotic scores in patients without diabetes. In contrast, we did not observe any significant correlation between metabolic syndrome score and coronary atherosclerotic scores in patients with diabetes. Multivariate regression analysis revealed that metabolic syndrome score is an independent predictor of atherosclerotic score in non-diabetics. Conclusion: While the relationship between metabolic syndrome score and angiographic coronary artery disease severity was disguised by the presence of diabetes, the metabolic syndrome score was related to the extent of coronary atherosclerosis in Indian patients without diabetes. Calculating the metabolic syndrome score might provide additional information for predicting the extent of coronary artery disease in patients with angina without diabetes.