The American study found that, after controlling for confounding factors such as smoking, drinking, and physical activity, there were no statistically significant associations between heart disease mortality and the components of MS (waist measurements, cholesterol levels, etc).
In fact, men and women with large waist sizes had lower risks for CVD mortality than the thinner-waisted. Moreover, these were Americans, who generally have larger waist sizes than the Japanese.
The assertion that those with MS (particularly those with large waists) are likely to develop heart disease and run a higher risk of dying from a heart attack is unproven hysteria on the part of the obesity-obsessed public health establishment. It is comparable to the discredited claims that those with BMIs in the overweight or obese category are likely to live shorter lives.