Metabolic syndrome cluster does not provide incremental prognostic information in patients with stable cardiovascular disease: A post hoc analysis of the AIM-HIGH trial

Radmila Lyubarova; Jennifer G Robinson; Michael Miller; Debra L Simmons; Ping Xu; Beth L Abramson; Marshall B Elam; Todd M Brown; Ruth McBride; Jerome L Fleg; Patrice Desvigne-Nickens; Woubeshet Ayenew; William E Boden; Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides and Impact on Global Health Outcomes (AIM-HIGH) Investigators

doi:10.1016/j.jacl.2017.06.017

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Metabolic syndrome cluster does not provide incremental prognostic information in patients with stable cardiovascular disease: A post hoc analysis of the AIM-HIGH trial

Journal article

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Metabolic syndrome cluster does not provide incremental prognostic information in patients with stable cardiovascular disease: A post hoc analysis of the AIM-HIGH trial

Radmila Lyubarova, Jennifer G Robinson, Michael Miller, Debra L Simmons, Ping Xu, Beth L Abramson, Marshall B Elam, Todd M Brown, Ruth McBride, Jerome L Fleg, …

Journal of clinical lipidology, Vol.11(5), pp.1201-1211

09/2017

DOI: 10.1016/j.jacl.2017.06.017

PMCID: PMC5612889

PMID: 28807460

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https://www.ncbi.nlm.nih.gov/pmc/articles/5612889View

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Abstract

Metabolic syndrome (MS) is a well-known risk factor for the development of cardiovascular (CV) disease; yet, controversy persists whether it adds incremental prognostic value in patients with established CV disease. This study was performed to determine if MS is associated with worse CV outcomes in patients with established CV disease treated intensively with statins. We performed a post hoc analysis of the Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides and Impact on Global Health Outcomes trial, in which patients with established CV disease and atherogenic dyslipidemia (n = 3414) were randomly assigned to receive extended release niacin or placebo during a mean 36-month follow-up, to assess whether the presence of MS or the number of MS components contributed to CV outcomes. The composite primary end point of CV events occurred in 15.1% of patients without MS vs 13.8%, 16.9%, and 16.8% of patients with MS in the subsets with 3, 4, and 5 MS components, respectively (corresponding adjusted hazard ratios 0.9, 1.1, and 1.1 relative to patients without MS), P = .55. Comparing subgroups with 3 vs 4 or 5 MS components, there was no significant difference in either the composite primary end point or secondary end points. Patients with diabetes mellitus had higher event rates, with or without the presence of MS. The presence of MS was not associated with worse CV outcomes in the AIM-HIGH population. The rate of CV events in statin-treated Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides and Impact on Global Health Outcomes patients with MS was not significantly influenced by the number of MS components. •Metabolic syndrome (MS) did not affect progression of atherosclerotic cardiovascular disease (ASCVD).•The number of MS components did not predict cardiovascular outcomes in established ASCVD.•Diabetes mellitus but not MS was associated with higher events in patients with established ASCVD.

Atherogenic dyslipidemia

Cardiovascular disease

Extended-release niacin

Metabolic syndrome

Diabetes mellitus

Details

Title: Subtitle: Metabolic syndrome cluster does not provide incremental prognostic information in patients with stable cardiovascular disease: A post hoc analysis of the AIM-HIGH trial
Creators: Radmila Lyubarova - Department of Medicine, Albany Medical Center, Albany Medical College, Albany, NY, USA
Jennifer G Robinson - Department of Epidemiology, College of Public Health, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
Michael Miller - Department of Medicine, University of Maryland Medical Center, Baltimore, MD, USA
Debra L Simmons - Department of Internal Medicine, University of Utah, Utah Diabetes and Endocrinology Center, Salt Lake City, UT, USA
Ping Xu - Axio Research LLC, Seattle, WA, USA
Beth L Abramson - Cardiac Prevention Centre and Women's Cardiovascular Health, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
Marshall B Elam - Memphis VA Medical Center, Memphis, TN, USA
Todd M Brown - Department of Medicine, University of Alabama Health Science Center at Birmingham, Birmingham, AL, USA
Ruth McBride - Axio Research LLC, Seattle, WA, USA
Jerome L Fleg - Division of Cardiovascular Science, National Institutes of Health, National Heart, Lung and Blood Institute, Bethesda, MD, USA
Patrice Desvigne-Nickens - Division of Cardiovascular Science, National Institutes of Health, National Heart, Lung and Blood Institute, Bethesda, MD, USA
Woubeshet Ayenew - Hennepin County Medical Center, Minneapolis, MN, USA
William E Boden - Department of Medicine, VA New England Healthcare System, Boston, MA, USA
Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides and Impact on Global Health Outcomes (AIM-HIGH) Investigators
Resource Type: Journal article
Publication Details: Journal of clinical lipidology, Vol.11(5), pp.1201-1211
DOI: 10.1016/j.jacl.2017.06.017
PMID: 28807460
PMCID: PMC5612889
NLM abbreviation: J Clin Lipidol
ISSN: 1933-2874
eISSN: 1876-4789
Publisher: Elsevier Inc
Grant note: DOI: 10.13039/100000050, name: National Heart, Lung, and Blood Institute, award: U01 HL081616, U01 HL081649
Language: English
Date published: 09/2017
Academic Unit: Epidemiology; Internal Medicine
Record Identifier: 9983996069402771

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