Center for the Early Diagnosis of Preclinical and Multifocal Atherosclerosis and for Secondary Prevention of Cardiovascular Diseases, Division of Cardiology, University Hospital Paolo Giaccone, 90127 Palermo, Italy.
Atherosclerosis. 2012 Aug;223(2):468-72. doi: 10.1016/j.atherosclerosis.2012.05.018. Epub 2012 May 30.
Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors, considered as emerging and promoting atherosclerosis. This study aimed at the evaluation of the influence of MetS on the prediction of cerebro and cardiovascular events during a 20 years follow-up period in an asymptomatic population of middle-aged subjects.
We evaluated 529 asymptomatic persons through a prospective study. Study population was divided into two subgroups: patients with and without MetS. Echo-color-Doppler was used in order to assess the presence of subclinical atherosclerosis. A 20 years follow-up study was carried out in order to estimate the incidence of cerebro and cardiovascular, fatal and non fatal, events (AMI, stroke, abdominal aortic aneurysm, TIA, angina pectoris).
242 cerebro and cardiovascular events were registered, 43 fatal (24 in MetS and 19 in controls) and 199 non fatal (120 with MetS and 79 without it, p < 0.0001). Free-events survival was lower in patients suffering from MetS (p < 0.0012; HR 0.6847; C.I.95%: 0.5274-0.8889). Ultrasound showed a higher prevalence of subclinical atherosclerosis in patients with MetS than in the unaffected ones (68.12% vs. 57.5% p < 0.01; OR = 1.58 with C.I.95% = 1.10-2.28, p < 0.01).
Patients with MetS have a higher cardiovascular risk that can be explained by atherosclerotic changes: the components of MetS interact to affect vascular thickness synergistically and promote the development of subclinical atherosclerosis. So we recommend to prevent the development of MetS abnormalities and to investigate the presence of subclinical atherosclerosis by echo-color-Doppler in order to stratify more accurately the global CV risk.
代谢综合征（MetS）是一组心血管危险因素，被认为是动脉粥样硬化的新兴和促进因素。本研究旨在评估代谢综合征对中年无症状人群 20 年随访期间脑卒中和心血管事件预测的影响。
我们通过前瞻性研究评估了 529 名无症状者。研究人群分为两组：有代谢综合征和无代谢综合征的患者。使用超声彩色多谱勒来评估亚临床动脉粥样硬化的存在。进行了 20 年的随访研究，以估计脑卒中和心血管、致命和非致命（AMI、卒、腹主动脉瘤、TIA、心绞痛）事件的发生率。
共登记了 242 例脑卒中和心血管事件，43 例死亡（代谢综合征 24 例，对照组 19 例）和 199 例非致命事件（代谢综合征 120 例，对照组 79 例，p<0.0001）。患有代谢综合征的患者无事件生存率较低（p<0.0012；HR 0.6847；95%CI：0.5274-0.8889）。超声显示，患有代谢综合征的患者亚临床动脉粥样硬化的患病率高于未受影响的患者（68.12%比 57.5%，p<0.01；OR=1.58，95%CI：1.10-2.28，p<0.01）。
患有代谢综合征的患者心血管风险较高，这可以用动脉粥样硬化变化来解释：代谢综合征的组成部分相互作用，协同影响血管壁厚度，并促进亚临床动脉粥样硬化的发展。因此，我们建议预防代谢综合征异常的发生，并通过超声彩色多谱勒检查来检测亚临床动脉粥样硬化的存在，以便更准确地分层评估总体心血管风险。
