Presence and Extent of Coronary Calcium in Patients with Metabolic Syndrome by MSCT

Abstract

Summary T his study aimed to evaluate the presence and the extent of coronary calcification in asymptomatic patients having metabolic syndrome. The study was conducted on 150 patients who fullified the criteria of metabolic syndrome according to the IDF definition. Patients were subjected to: A- Assessment of risk factors for atherosclerosis including: Age, sex, family history, diabetes mellitus, hypertension, smoking, Dyslipidemia, BMI and waist circumference. B- Assessment of metabolic syndrome criteria according to IDF definition (47) which included: 1. Central obesity based on waist circumference ≥94cm for males and ≥ 80 cm for females and/or BMI >30. Plus two of the following: a. Raised fasting serum triglycerides levels ≥150 mg/dl (1.7mmol/l). b. Reduced high density lipoprotein cholesterol level < 40mg/dl (1.03mmol/l) for males or <50 mg/dl (1.29 mmol/l) for females. c. Raised blood pressure ≥130mmhg systolic or ≥85mmhg diastolic or on treatment of previously diagnosed hypertension. d. Raised fasting plasma glucose level ≥100mg/dl (5.6mmol/l), or previously diagnosed type 2 DM. C- Multi-slices CT coronary angiography to measure the following: 1- Coronary calcium score: The amount of calcium present in the coronary arteries was scored according to the Agatson scale (10), as follows: • 0 – no identifiable disease • 1 to 99 - mild disease • 100 to 399 - moderate disease • 400 or higher - severe disease In addition to calculating the total calcium score, the following data were also collected. 2- Calcium volume score: it represents volume of calcification throughout the vessels. 3- Number of affected vessels.

Results of this study showed the following: 1- Increased prevalence of coronary calcification among patients with metabolic syndrome. 2- The risk of coronary calcification increased with the increasing number of Metabolic syndrome components 3- Waist circumference was an independently significant risk factor for the presence and extent of coronary calcification where as BMI was not. 4- Hypertension, DM, and decreased HDL.C levels were significant risk factors associated with the presence and extent of coronary calcification 5- Significant Association between elevated total cholesterol level , LDL.C level and coronary calcification 6- Elevated TG was not significantly associated with presence or extent coronary calcification 7- The prevalence and extent of CAC had an ascending trend with increasing age, in males and smokers 8- Family history was not significantly associated with coronary calcification.