Metabolic syndrome versus C-reactive protein as cardiovascular risk factors in African-Americans and European-Americans
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Insulin resistance and inflammation may synergistically interact in increasing coronary artery disease (CAD) risk. The study was designed to investigate the association of C-reactive protein (CRP) and metabolic syndrome (NCEP ATP III criteria) with CAD in 224 African-Americans and 304 European-Americans undergoing coronary angiography, CAD being defined as ≥50% stenosis in any segment or as a composite cardiovascular score. The relative frequencies of metabolic syndrome and CAD were significantly higher in African-Americans with high (≥3 mg/L) versus low (<3 mg/L) CRP levels while, in both ethnic groups, composite scores were higher in subjects with high versus low CRP levels. Moreover, in both ethnic groups, cardiovascular scores were higher in subjects with metabolic syndrome, regardless of CRP levels. After adjusting for other risk factors, multiple regression analysis revealed an independent association of metabolic syndrome, but not CRP, with CAD in European-Americans but not in African-Americans. In conclusion, metabolic syndrome was independently associated with CAD in both ethnic groups whilst CRP did not add prognostic information beyond established cardiovascular risk factors in either ethnic group.
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