Key Factors Raise Clogged Artery Risk

Metabolic syndrome plus vascular calcium greatly boost the odds, study finds

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TUESDAY, May 31, 2005 (HealthDay News) -- People with metabolic syndrome -- a constellation of risk factors for heart disease -- and moderate levels of calcium in their coronary arteries are at increased risk of developing blockages in those arteries, researchers report.

Metabolic syndrome is defined as having at least three of the following disorders at the same time: abdominal obesity, high blood sugar, abnormal cholesterol levels and high blood pressure. About 40 percent of adults in the United States have metabolic syndrome, which can lead to diabetes and accelerated heart disease.

Published in the June issue of the journal Diabetes Care, the study of more than 1,000 patients found that analyzing a person's metabolic profile in relation to their coronary calcium levels can help identify those who need a stress imaging test in order to determine proper treatment.

"Metabolic syndrome is very similar to diabetes in accelerating heart disease," study senior author Dr. Daniel Berman, director of cardiac imaging at Cedars-Sinai Medical Center in Los Angeles, said in a prepared statement.

"Importantly, our findings reveal that patients with the metabolic syndrome who had only moderate amounts of calcium in their coronary arteries had a significantly greater chance of having ischemia -- too little blood flow to the heart -- during a stress test," Berman said.

Coronary calcium indicates the presence of plaque build-up in the arteries surrounding the heart. The amount of coronary calcium is measured using computed tomography (CT) and is called a calcium score. Calcium scores of zero are the best; scores from one to 100 are mild; scores of 100 to 400 are moderate; and scores over 400 indicate extensive coronary calcium.

Those with mild calcium scores are considered at low risk for any cardiac event over the following five years, while those with moderate scores are at increased or intermediate risk for cardiac events. People with high calcium scores are at high risk.

"Our findings suggest that patients' coronary calcium scans need to be interpreted in light of whether or not they have metabolic syndrome or diabetes, in order for us to best determine which patients need to be referred for stress testing," Berman said.

"Contrary to previous thinking, our data show that patients with the metabolic syndrome or diabetes deserve earlier stress testing than patients without those metabolic abnormalities," he said.

"If our findings are confirmed in additional clinical trials, the practice guidelines for stress testing are likely to be changed so that more patients with metabolic syndrome can be stress tested, allowing those with ischemia -- those who are at highest risk for heart attack -- to be identified and appropriately treated."

More information

The American Heart Association has more about metabolic syndrome.

SOURCE: Cedars-Sinai Medical Center, news release, May 26, 2005

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