Metabolic syndrome and 10-year cardiovascular disease incidence: The ATTICA study.

AIMS: To evaluate the influence of metabolic syndrome (MetS) as well as inflammatory and renal markers on cardiovascular disease (CVD) incidence. METHODS AND RESULTS: During 2001-2002, 1514 men and 1528 women (>18 y) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, Greece, were enrolled. In 2011-2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD was defined according to WHO-ICD-10 criteria. MetS was defined using three definitions, provided by the National Cholesterol Education Program Adult Treatment panel III (revised NCEP ATP III), the International Diabetes Federation (IDF) or the Harmonized definition. Furthermore, the contributory predictive role of C-reactive protein (CRP), inteleukin-6, uric acid and estimated glomerular filtration rate in the aforementioned models was evaluated. History of MetS-NCEP was positively associated with CVD, adjusting for potential confounding factors (OR:1.83, 95%CI:1.24-2.72). Not statistically significant associations with CVD incidence were observed when using the IDF or the Harmonized definition. Additionally, none of the added inflammatory and renal function markers mediated the influence of MetS on CVD incidence (all p's from Sobel test >0.40). C-statistic values for the MetS definitions used exceeded 0.789 (CI:0.751-0.827), indicating fair-to-good predictive probability of the models. CONCLUSION: Results of the present work revealed the negative impact of MetS-NCEP, but not of the other MetS definitions, on CVD incidence, a key-point that may help in better understanding the role of IDF and Harmonized MetS definitions on CVD.

Moderate fish consumption is associated with lower likelihood of developing Left Ventricular Systolic Dysfunction in acute coronary syndrome patients.

The aim of the present work was to evaluate the association between fish consumption and the development of left ventricular systolic dysfunction in patients who have had an acute coronary syndrome (ACS). During 2006 to 2009, 934 consecutive ACS patients were included in the study; 437 patients who developed LVSD, 347 male (64 +/- 13 y) and 90 female (71 +/- 12 y), and 497 patients with preserved systolic function, 388 male (62 +/- 12 y) and 109 female (66 +/- 12 y). Detailed information regarding their medical records, anthropometric data, physical activity, and smoking habits were recorded. Nutritional habits were assessed using a semiquantitative food-frequency questionnaire. Multi-adjusted analysis revealed that moderate fish consumption was associated with 53% (95% CI: 0.22 to 0.97) lower likelihood of developing left ventricular systolic dysfunction, compared to no/rare consumption, after adjustment for various confounding factors. Furthermore, moderate fish consumption was associated with lower values of the endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine (P = 0.05) and oxidized LDL cholesterol (P = 0.02) in patients who did not develop left ventricular systolic dysfunction. Moderate fish consumption seems to offer significant protection against the development of systolic dysfunction in post ACS patients, merely attributed to its beneficial effect on oxidation process and endothelial function.