Cardiovascular Risk Stratification in Patients With Metabolic Syndrome Without Diabetes or Cardiovascular Disease: Usefulness of Metabolic Syndrome Severity Score

High Blood Press Cardiovasc Prev. 2017 Sep;24(3):297-303. doi: 10.1007/s40292-017-0209-0. Epub 2017 May 13.

Abstract

Introduction: The estimated cardiovascular risk determined by the different risk scores, could be heterogeneous in patients with metabolic syndrome without diabetes or vascular disease. This risk stratification could be improved by detecting subclinical carotid atheromatosis.

Aims: To estimate the cardiovascular risk measured by different scores in patients with metabolic syndrome and analyze its association with the presence of carotid plaque.

Methods: Non-diabetic patients with metabolic syndrome (Adult Treatment Panel III definition) without cardiovascular disease were enrolled. The Framingham score, the Reynolds score, the new score proposed by the 2013 ACC/AHA Guidelines and the Metabolic Syndrome Severity Calculator were calculated. Prevalence of carotid plaque was determined by ultrasound examination. A Receiver Operating Characteristic analysis was performed.

Results: A total of 238 patients were enrolled. Most patients were stratified as "low risk" by Framingham score (64%) and Reynolds score (70.1%). Using the 2013 ACC/AHA score, 45.3% of the population had a risk ≥7.5%. A significant correlation was found between classic scores but the agreement (concordance) was moderate. The correlation between classical scores and the Metabolic Syndrome Severity Calculator was poor. Overall, the prevalence of carotid plaque was 28.2%. The continuous metabolic syndrome score used in our study showed a good predictive power to detect carotid plaque (area under the curve 0.752).

Conclusion: In this population, the calculated cardiovascular risk was heterogenic. The prevalence of carotid plaque was high. The Metabolic Syndrome Severity Calculator showed a good predictive power to detect carotid plaque.

Keywords: Cardiovascular risk estimation; Carotid atherosclerotic plaque; Metabolic syndrome; Risk scores.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Area Under Curve
  • Argentina / epidemiology
  • Asymptomatic Diseases
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Artery Diseases / epidemiology
  • Carotid Intima-Media Thickness*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Metabolic Syndrome / diagnosis*
  • Metabolic Syndrome / epidemiology
  • Middle Aged
  • Plaque, Atherosclerotic
  • Predictive Value of Tests
  • Prevalence
  • ROC Curve
  • Reproducibility of Results
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index