# Associations of metabolic syndrome and albuminuria with all-cause mortality in patients with coronary artery disease and no history of diabetes: A cohort study

## TL;DR

The study found that albuminuria, but not metabolic syndrome, is linked to higher mortality in coronary artery disease patients without diabetes.

## Contribution

Albuminuria is independently associated with mortality in coronary artery disease patients without diabetes, offering a new risk identification tool.

## Key findings

- Metabolic syndrome was not linked to all-cause mortality in coronary artery disease patients without diabetes.
- Albuminuria was independently associated with increased all-cause mortality in the same patient group.
- Screening for albuminuria may help identify high-risk coronary artery disease patients without diabetes.

## Abstract

•Patients with coronary artery disease but no history of diabetes were investigated.•We examined associations of metabolic syndrome and albuminuria with mortality.•Metabolic syndrome was not associated with all-cause mortality in these patients.•Presence of albuminuria was independently associated with all-cause mortality.•Screening for albuminuria may help identify high-risk patients in this population.

Patients with coronary artery disease but no history of diabetes were investigated.

We examined associations of metabolic syndrome and albuminuria with mortality.

Metabolic syndrome was not associated with all-cause mortality in these patients.

Presence of albuminuria was independently associated with all-cause mortality.

Screening for albuminuria may help identify high-risk patients in this population.

Metabolic syndrome is a constellation of cardiovascular risk factors and has been associated with a higher risk of mortality. Albuminuria was previously part of the criteria for metabolic syndrome. We investigated the associations of albuminuria and metabolic syndrome with all-cause mortality among patients with coronary artery disease.

We enrolled patients who had coronary angiography-proved coronary artery disease but no history of diabetes between 2009 and 2013. All patients underwent an oral glucose tolerance test to determine their glucose regulation state. Metabolic syndrome was determined using the criteria of National Cholesterol Education Program Adult Treatment Panel III. A spot urine sample was collected to determine the urinary albumin to creatinine ratio (UACR). Information on all-cause mortality was confirmed until March 2023. Cox-proportional hazard models were conducted to examine the associations of metabolic syndrome and albuminuria with all-cause mortality.

A total of 823 patients with coronary artery disease were analysed. After a median follow-up period of 8.94 years, patients with metabolic syndrome had no significant difference in all-cause mortality compared with those without metabolic syndrome (adjusted hazard ratio [HR] 0.826, 95% CI 0.568–1.201, p = 0.317). In contrast, patients with albuminuria (UACR ≥ 30 mg/g) had an independently higher risk of all-cause mortality (adjusted HR 1.529, 95% CI 1.057–2.212, p = 0.024) compared with those who had normoalbuminuria.

Albuminuria was independently associated with all-cause mortality in patients with coronary artery disease but no history of diabetes, while the presence of metabolic syndrome was not.

Image, graphical abstract