Patients with
metabolic syndrome are at high-risk for development of
atherosclerosis and cardiovascular events. The objective of this study was to examine the major determinants of
coronary disease severity, including those coronary risk factors associated with
metabolic syndrome, during the early period after an acute coronary episode. We tested the hypothesis that inflammatory markers, especially highly sensitive
C-reactive protein (
hsCRP), are related to
coronary atherosclerosis, in addition to traditional coronary risk factors. Subjects of both genders aged 30 to 75 years (N = 116) were prospectively included if they had suffered a recent
acute coronary syndrome (acute
myocardial infarction or
unstable angina pectoris requiring hospitalization) and if they had
metabolic syndrome diagnosed according to the National
Cholesterol Education Program/Adult Treatment Panel III. Patients were submitted to a coronary angiography and the burden of
atherosclerosis was estimated by the Gensini score. The severity of
coronary disease was correlated (Spearman's or Pearson's coefficient) with gender (r = 0.291, P = 0.008), age (r = 0.218, P = 0.048),
hsCRP (r = 0.256, P = 0.020),
ApoB/
ApoA ratio (r = 0.233, P = 0.041), and carotid intima-media thickness (r = 0.236, P = 0.041). After multiple linear regression, only male gender (P = 0.046) and
hsCRP (P = 0.012) remained independently associated with the Gensini score. In this high-risk population, male gender and high levels of
hsCRP, two variables that can be easily obtained, were associated with more extensive
coronary disease, identifying patients with the highest potential of developing new coronary events.