AbstractBackground: The aim of our study was to determine the coronary angiographic distribution and frequency of atherosclerotic lesions in the coronary arteries in patients with stable angina and metabolic syndrome (MS) as well as to assess the association of these lesions with TIMI frame count and combinations of MS criteria.Methods: Two hundred sixty-one patients aged 61.8±1.4 years were included in the study. All subjects were divided into three large groups: group 1 - patients with significant coronary artery stenosis and with MS (n=148), group 2 - patients with significant coronary artery stenosis and without MS (n=75), and group 3 - patients without significant coronary artery stenosis and without MS (n=38). At the same time, the patients in group 1 were again divided into 3 subgroups based on the number of MS criteria. Arterial blood pressure (BP), waist circumference (WC), and levels of fasting glucose (FG), triglycerides (TG) and high-density lipoproteins (HDL) were measured in all patients. All subjects underwent coronary angiography and TIMI frame count was calculated.Results: According to the results in patients with stable angina with 5 criteria of MS, the TIMI frame count was significantly greater than in patients with stable angina with 3 and 4 criteria of MS. While in the group of patients with stable angina with 3 criteria of MS, the most frequent combination found was BP +WC + FG (28.3±6.2%), in patients with stable angina with 4 MS criteria, it was BP + WC + FG + HDL combination (48.0±7.1%).Conclusions: The TIMI frame count method is simple, inexpensive and broadly applicable and plays role in the understanding of the physiology and pathophysiology of coronary artery blood flow in patients with stable angina and MS. For this reason, the calculation of TIMI frame count in patients with stable angina and MS has an important place in selecting the treatment options and determining the prognosis of the disease. Turk Jem 2011; 15: 1-7