Metabolic Syndrome Metabolic Syndrome and Risk of Incident Peripheral Artery Disease The Cardiovascular Health Study Parveen K. Garg, Mary L. Biggs, Mercedes Carnethon, Joachim H. Ix, Michael H. Criqui, Kathryn A. Britton, Luc Djoussé, Kim Sutton-Tyrrell,* Anne B. Newman, Mary Cushman, Kenneth J. Mukamal Abstract—Prior studies evaluating metabolic syndrome (MetS) and incident peripheral artery disease (PAD) have been limited by use of modified MetS criteria and restriction to clinical PAD end points. We investigated MetS and risk of developing a low ankle-brachial index (ABI) and clinical PAD in the Cardiovascular Health Study, a population-based cohort of adults aged ≥65 years. Participants with MetS met at least 3 of 5 Adult Treatment Panel III criteria. Baseline C-reactive protein-MetS or fibrinogen-MetS were defined as presence of 3 of 6 components, with elevated C-reactive protein (>3 mg/L) or fibrinogen (>341 mg/dL) as a sixth component. Incident low ABI, defined as ABI