Abstract
Abstract 202: Insulin Resistance as an Independent Predictor of Atherosclerosis Burden in Nondiabetic Patients with Acute Myocardial Infarction
Circulation research, Vol.111(suppl_1)
08/03/2012
DOI: 10.1161/res.111.suppl_1.A202
Abstract
Introduction:
Experimental evidence suggests that insulin resistance (IR) is a major risk factor for accelerated atherosclerosis through indirect effects on systemic risk factors and direct effects on insulin signaling in vascular endothelium and plaque macrophages.
Hypothesis:
IR in persons without diabetes mellitus is associated with multi-vessel coronary artery disease (CAD) in acute myocardial infarction (AMI) patients.
Methods:
We examined 1111 non-diabetic AMI patients (HbA1c ≤ 6.5) enrolled in the multicenter TRIUMPH (years 2004-2008) registry. IR was estimated using the homeostasis model assessment of IR (HOMA-IR: fasting insulin (mU/l) x fasting blood glucose (mmol/l)]/22.5). The primary outcome was the extent of angiographic atherosclerosis (≤1-vessel vs. multi-vessel disease). Modified Poisson regression models were used to examine the association between IR and multi-vessel CAD.
Results:
Subjects were divided into quartiles based on HOMA-IR values (quartile 1: male <=1.35, female <=1.26; quartile 4: male >4.00, female >3.64). After adjusting for age, sex, hypertension, smoking, family history of CAD, LDL, HDL, and body mass index (BMI), IR was independently associated with multi-vessel CAD (Figure). As compared to the lowest quartile of IR, the highest quartile had more multi-vessel CAD [RR (95% CI)- 1.35 (1.11-1.64)].
Conclusion:
In a large cohort of non-diabetic AMI patients, IR was associated with more advanced, multi-vessel CAD, independent of lipid levels and other components of the metabolic syndrome. This association is consistent with established experimental evidence and supports IR as a potential target for preventing atherosclerosis.
Details
- Title: Subtitle
- Abstract 202: Insulin Resistance as an Independent Predictor of Atherosclerosis Burden in Nondiabetic Patients with Acute Myocardial Infarction
- Creators
- Wassef Karrowni - Roy J. and Lucille A. Carver College of MedicineYan Li - Saint Luke's HospitalPhilip G Jones - Saint Luke's HospitalDonna M Buchanan - Saint Luke's HospitalRamzi El Accaoui - Roy J. and Lucille A. Carver College of MedicineSharon Cresci - Washington University in St. LouisMouin Abdallah - Saint Luke's HospitalDavid E Lanfear - Henry Ford HospitalThomas M Maddox - VA Eastern Colorado Health Care SystemDarren K McGuire - The University of Texas Southwestern Medical CenterJohn A Spertus - Saint Luke's HospitalPhillip A Horwitz - University of Iowa
- Resource Type
- Abstract
- Publication Details
- Circulation research, Vol.111(suppl_1)
- DOI
- 10.1161/res.111.suppl_1.A202
- ISSN
- 0009-7330
- eISSN
- 1524-4571
- Language
- English
- Date published
- 08/03/2012
- Academic Unit
- Radiology; Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984362736402771
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