As compared with patients with no METS and no type @ diabetes mellitus ( DM ) , the risk of all-cause and HF death was significantly lower in patients with METS and no DM ( HR : @ , @ % CI : @ to @ , p = @ ; HR : @ , @ % CI : @ to @ , p = @ ; respectively ) , whereas it was significantly increased in patients with DM and no METS ( HR : @ , @ % CI : @ to @ , p < @ ; HR : @ , @ % CI : @ to @ , p < @ ; respectively ) .