AbstractINTRODUCTION: In view of the high prevalence of coronary artery diseases (CAD)and the fact that the metabolic syndrome is known to predispose to CAD, we studied therelationship between various components of the metabolic syndrome and the severity ofCAD.METHODS: A total of 545 patients with stable angina were included in this crosssectionalstudy. Questionnaires were used to obtain information on demographiccharacteristics, drug history, and history of previous hospitalization. Blood pressure (BP)and waist circumference (WC) were measured. Ten-hour fasting blood samples weretaken to measure blood sugar, high-density lipoprotein cholesterol (HDL-C), andtriglyceride (TG) using autoanalyzer. Angiography was performed with the standardmethod and the patients were scored using extent scoring. The metabolic syndrome wasdefined according to ATP-III. SPSS 11 was use to analyze data with t-test, ANOVA,correlation and logistic regression tests.RESULTS: The patients had a mean age of 57.93±10.13 years. High HDL-C was themost frequent abnormality, followed by increased WC and TG. Severity of metabolicsyndrome increased with age. CAD was detected in 78.9% of patients with the metabolicsyndrome and 46.7% of patients without it (P<0.05). In regression analysis, themetabolic syndrome was found to be a risk factor for CAD (OR=1.35, CI=1.13-1.60).Direct correlation was found between angiography score and metabolic syndrome(P<0.01, r=0.15).CONCLUSIONS: The metabolic syndrome is a predisposing factor to CAD; hence CADprevention should involve measures to control metabolic syndrome, especially throughlifestyle modification.Key Words: Metabolic syndrome, CAD.