Diabetes exacerbates angiographic coronary lesion progression in subjects with metabolic syndrome independent of CRP levels.

Abstract Background Metabolic syndrome is gaining more attention as a special cluster of cardiovascular risks. However, its role, with or without diabetes, in predicting atherosclerosis progression, remains largely undetermined. We investigated the predictors for angiographic coronary atherosclerosis progression in patients with metabolic syndrome and angina pectoris. Methods Patients with metabolic syndrome and angina pectoris who underwent repeat coronary angiograms and had serum samples at the time of first catheterization were enrolled for analysis ( N  = 113). A modified Gensini scoring system was used to define CAD progression between the index and follow-up angiograms. Those who had significant angiographic progression of coronary disease were classified as the progression group ( N  = 42) and those who did not as the non-progression group ( N  = 71). Results There were more cases of diabetes mellitus (52% vs. 31%, p  = 0.040) in the CAD progression group. The progression group also had higher baseline fasting blood glucose (150 ± 73 vs. 117 ± 46 mg/dl, p  = 0.010) but similar LDL cholesterol (114 ± 38 vs. 109 ± 33 mg/dl, p  = 0.421) than the non-progression group. In terms of inflammatory markers, there was no difference in hs-CRP ( p  = 0.208), MCP-1 ( p  = 0.514), or sCD40L ( p  = 0.549) between the groups. In binary logistic regression, diabetes mellitus remained a significant predictor of CAD progression (OR 2.43, p  = 0.030) for patients with metabolic syndrome and angina pectoris, but hs-CRP and LDL-C were not. Conclusion Diabetes mellitus, but not inflammatory marker hs-CRP or LDL-C, is a significant predictor of angiographic CAD progression in patients with metabolic syndrome and angina pectoris.