The metabolic syndrome and risk of major coronary events in the Scandinavian Simvastatin Survival Study (4S) and the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS)☆
Section snippets
Study design
These post hoc analyses included only those patients who received placebo from the 4S and AFCAPS/TexCAPS trials. Methods for 4S and AFCAPS/TexCAPS have been previously described.2, 3, 4, 5, 6 Briefly, the 4S study was a double-blind randomized, placebo-controlled clinical trial assessing the effects of simvastatin (Zocor, Merck & Co., Inc., Rahway, New Jersey) 20 mg (titrated to 40 mg as needed) versus placebo on mortality and morbidity; 4,444 men and women with a history of angina pectoris or
Baseline characteristics
Mean ± SD age of the patients who received placebo in both studies was approximately 58 ± 7 years, and most patients were men (79% to 85%) (Table 1). Average baseline body mass index was approximately 26 to 27 kg/m2 and mean systolic blood pressure was 138 to 139 mm Hg. As expected by study design, mean low-density lipoprotein (LDL) levels were higher in 4S than in AFCAPS/TexCAPS, whereas average HDL was lower and triglycerides higher in AFCAPS/TexCAPS than in 4S.
Prevalence of the metabolic syndrome and components:
At baseline in 4S, 411 of
Discussion
Results of post hoc analyses of 4S and AFCAPS/TexCAPS trials demonstrate a clear, statistically significant increase in risk of MCEs for placebo-treated patients meeting criteria for the metabolic syndrome. The risk of MCEs for placebo-treated patients with clinically established CHD and high LDL cholesterol levels (4S) or no CHD but low HDL (AFCAPS/TexCAPS) was increased 1.4 to 1.5-fold after excluding patients with diabetes mellitus. One might have expected a somewhat weaker association in
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2018, GeneCitation Excerpt :Other studies have shown that MetS is associated with a pro-inflammatory state and raised VEGF (Wada et al., 2010; Lakka et al., 2002; Gu et al., 2005; Lorenzo et al., 2007). Several studies have shown that MetS and its risk factors increase the risk of CVD, chronic kidney diseases (CKD), cancer, insulin resistance, diabetes mellitus and insulin resistance (Isomaa et al., 2001; Lakka et al., 2002; Sattar et al., 2003; McNeill et al., 2005; Girman et al., 2004; Ford et al., 2010; Tanaka et al., 2006; Kitiyakara et al., 2007; Jialal et al., 2010; Zimmet et al., 1999). Increased serum VEGF concentrations were also reported in several studies in the patient with MetS and its individual components (Lorenzo et al., 2007; Siervo et al., 2010; Stumpf et al., 2009; Sandhofer et al., 2009), essential hypertension, type 2 diabetes mellitus, and coronary heart disease (Sandhofer et al., 2009; Petrovič et al., 2007; Kubisz et al., 2010; Kristensen et al., 2009; Barylski et al., 2009; Ebinç et al., 2008; Belgore et al., 2000), uncomplicated hyperlipidemia patients (Silha et al., 2005) and hypercholesterolemia patients (Miyazawa-Hoshimoto et al., 2003).
Dyslipidemia
2018, Canadian Journal of DiabetesRisk of acute coronary syndrome and peripheral arterial disease in chronic liver disease and cirrhosis: A nationwide population-based study
2018, AtherosclerosisCitation Excerpt :In addition, Willner et al. have discovered that 90% of nonalcoholic steatohepatitis patients have underlying insulin resistance and family tendency toward metabolic syndrome [30]. Since metabolic syndrome is recognized as a risk factor for atherosclerosis [31], the postulated link is metabolic syndrome, which coexists with both nonalcoholic fatty liver disease and coronary plaques [32]. Chen et al. and Lai et al. have reported that the prevalence of nonalcoholic fatty liver disease in Taiwan is 11.5%–36.9% [33,34].
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The 4S and AFCAPS/TexCAPS clinical trials were supported by Merck & Co., Inc., Rahway, New Jersey.