{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:30:11Z","timestamp":1777447811051,"version":"3.51.4"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","award":["T32 GM152318"],"award-info":[{"award-number":["T32 GM152318"]}],"id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","award":["GM007356"],"award-info":[{"award-number":["GM007356"]}],"id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>We have previously shown an association between metabolic syndrome (MS) and heart failure (HF) outcomes in patients with implantable cardioverter defibrillators (ICDs) or cardiac resynchronization therapy with defibrillator (CRT-D). However, the role of MS in predicting outcomes was not assessed in non-obese patients. We aimed to examine how the presence of MS and its components predicts the risk of HF\/death in non-obese ICD or CRT-D patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included obese and non-obese patients, enrolled in Multicenter Automatic Defibrillator Implantation Trial\u2013Cardiac Resynchronization Therapy (MADIT-CRT). Patients needed at least 2 of the 3 criteria, dyslipidaemia, diabetes, or hypertension, to be considered for having MS. Kaplan\u2013Meier analyses were used to assess the rate of HF\/death by MS. Multivariate Cox-proportional analyses were performed to assess the risk of HF\/death by MS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 1180 (65%) non-obese patients in MADIT-CRT, 672 (57%) presented with MS. Among non-obese patients with MS, 284 (42%) had diabetes mellitus. Non-obese MS patients had a significantly higher, 34% cumulative probability of HF\/death at 3 years, as compared to the 20% of non-obese patients without MS (log-rank P &amp;lt; .001) (hazard ratio: 1.64, 95% CI: 1.15\u20132.32, P &amp; .006). Within non-obese MS patients, those with diabetes had a significantly higher rate of HF\/death with 28% vs. 20% in non-diabetics at 2.5 years (log-rank P &amp;lt; .001). Reverse remodelling was similar in all subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MS in non-obese ICD or CRT-D patients is associated with a higher risk of HF\/Death, most prominent in those with diabetes, necessitating early intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag073","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T12:35:13Z","timestamp":1773146113000},"source":"Crossref","is-referenced-by-count":0,"title":["Effects of metabolic syndrome on cardiovascular outcomes in non-obese heart failure patients"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6742-915X","authenticated-orcid":false,"given":"Daniel D","family":"Han","sequence":"first","affiliation":[{"name":"Medical Scientist Training Program (MSTP), School of Medicine & Dentistry, University of Rochester , Rochester, NY, USA"},{"name":"Clinical Cardiovascular Research Center, University of Rochester Medical Center , 265 Crittenden Blvd., Box 653, Rochester, NY 14642, USA"},{"name":"Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester Medical Center , Rochester, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Miedlich","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism, University of Rochester Medical Center , Rochester, NY ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane","family":"Morse","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Rochester , Rochester, NY ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert C","family":"Block","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Rochester , Rochester, NY ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4146-420X","authenticated-orcid":false,"given":"Wojciech","family":"Zareba","sequence":"additional","affiliation":[{"name":"Clinical Cardiovascular Research Center, University of Rochester Medical Center , 265 Crittenden Blvd., Box 653, Rochester, NY 14642, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5806-3325","authenticated-orcid":false,"given":"Ilan","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"Clinical Cardiovascular Research Center, University of Rochester Medical Center , 265 Crittenden Blvd., Box 653, Rochester, NY 14642, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"McNitt","sequence":"additional","affiliation":[{"name":"Clinical Cardiovascular Research Center, University of Rochester Medical 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