Metabolic syndrome does not predict an increased risk of coronary disease in patients with traditional risk factors referred for stress imaging study.

BACKGROUND: The impact of metabolic syndrome on the prediction of coronary artery disease (CAD) in subjects with multiple traditional risk factors is unknown. METHODS: We enrolled 2,626 consecutive subjects who underwent clinically indicated stress imaging studies using echocardiography or single-photon emission computed tomography (SPECT) myocardial perfusion. Patients with known CAD were excluded leaving 1256 subjects. Metabolic syndrome was defined by National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. The number of traditional risk factors and the presence of metabolic syndrome were compared with the results of stress imaging. Logistic regression analysis was used to assess the impact of metabolic syndrome on CAD prevalence in subjects with limited (or=3) risk factors. RESULTS: Metabolic syndrome was present in 540 (43%) of subjects. Presence of metabolic syndrome was associated with a nonsignificant 3%-4% increase in overall prevalence of CAD. Metabolic syndrome did not increase the prevalence of CAD in those with multiple (>or=3) traditional risk factors (metabolic syndrome 25% vs. no metabolic syndrome 21%, P = 0.62) or in those with limited (