The role of insulin resistance and metabolic risk factors on culprit coronary plaque

Park, Yae Min; Han, Seung Hwan; Seo, Jong Goo; Lee, Sihoon; Oh, Pyung Chun; Koh, Kwang Kon; Lee, Kyounghoon; Suh, Soon Yong; Kang, Woong Chol; Ahn, Taehoon; Choi, In Suck; Shin, Eak Kyun

doi:10.1016/j.ijcard.2015.04.163

Cited by 6 publications

(5 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The IR was also related to greater plaque necrotic core and more positive remodeling caused by atherosclerotic plaque accumulation. 6,20 However, IVUS-defined lipid-rich plaques might not be the major marker of plaque vulnerability. Optical coherence tomography could accurately identify TCFA and FCT due to its high resolution.…”

Section: Discussionmentioning

confidence: 99%

“…4 Recent studies using intravascular ultrasound (IVUS) indicated that more lipid-rich plaque and larger necrotic core were observed in patients with CAD presented with IR. 5,6 Abundant intravascular imaging studies have defined thincap fibroatheroma (TCFA) and macrophage infiltration as vulnerable plaque features. 7 Both TCFA and macrophages were shown to be related to IR in a previous study.…”

Section: Introductionmentioning

confidence: 99%

“…4 Recent studies using intravascular ultrasound (IVUS) indicated that more lipid-rich plaque and larger necrotic core were observed in patients with CAD presented with IR. 5,6…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Association Between Insulin Resistance and Coronary Plaque Vulnerability in Patients With Acute Coronary Syndromes: Insights From Optical Coherence Tomography

Liu

et al. 2018

Angiology

View full text Add to dashboard Cite

We investigated the correlation between insulin resistance (IR) and optical coherence tomography and identified culprit plaque characteristics in patients with acute coronary syndrome (ACS). Patients with ACS who underwent selective coronary intervention were prospectively enrolled. A total of 159 culprit lesions were identified in 145 patients. Culprit plaque characteristics, including thin-cap fibroatheroma (TCFA) and spotty calcification, were analyzed. The IR was assessed using the homeostasis model assessment of IR (HOMA-IR). Patients were divided into 4 interquartile ranges (IQRs) according to HOMA-IR values. The prevalence rates of TCFA were significantly different among the 4 groups (17.5% [IQR1 group] vs 17.9% [IQR2 group] vs 35.0% [IQR3 group] vs 55.0% [IQR4 group]; P ¼ .001). Minimal fibrous cap thickness was inversely correlated with HOMA-IR level (141.35 [56.28] mm vs 142.82 [82.17] mm vs 102.14 [36.52] mm vs 96.00 [41.82] mm; P < .001). Spotty calcification prevalence was also significantly different among the 4 groups (5.9% vs 17.6% vs 32.4% vs 44.1%; P < .001). Compared with the bottom quartile, patients with elevated HOMA-IR values had higher prevalence of macrophage infiltration (P < .001) and microvessels (P ¼ .023). On multivariate analysis, Ln HOMA-IR (odds ratio: 6.022; 95% confidence interval: 3.007-12.060; P < .001) was the independent predictor for spotty calcification. The current study showed increased IR was independently associated with plaque vulnerability, spotty calcification in particular, in ACS.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association Between Insulin Resistance and Coronary Plaque Vulnerability in Patients With Acute Coronary Syndromes: Insights From Optical Coherence Tomography

Liu

et al. 2018

Angiology

View full text Add to dashboard Cite

show abstract

“…In addition, subjects with metabolic syndrome had increased cardiovascular events and all-cause mortality [ 11 ]. Although poor clinical outcomes of metabolic syndrome are partly explained by consequence of insulin resistance and abnormal endothelial function [ 22 – 25 ], there are still limited data on the mechanisms of poor outcomes in subjects with metabolic syndrome for cardiovascular disease. In current out study, abnormal metabolic conditions such as metabolic syndrome and diabetes mellitus had greater arterial stiffness than in subjects with healthy metabolic state, these results suggest that increased arterial stiffness in subjects with abnormal metabolic conditions is one of the mechanisms for the poor cardiovascular outcomes in subjects with abnormal metabolic conditions.…”

Section: Discussionmentioning

confidence: 99%

The role of abnormal metabolic conditions on arterial stiffness in healthy subjects with no drug treatment

Hwang

Kim

et al. 2016

Clin Hypertens

Self Cite

View full text Add to dashboard Cite

BackgroundSubjects with abnormal metabolic conditions had increased risk for cardiovascular disease. We investigated the role of abnormal metabolic conditions on arterial stiffness in healthy subjects with no drug treatment.MethodsA total 601 subjects (age 48.7 ± 11.8 years, male 46.2 %, hypertension 19.1 %) were enrolled. Major cardiovascular risk factors, metabolic conditions and parameters (pre-diabetes, diabetes mellitus, metabolic syndrome, fasting blood sugar (FBS), glycated hemoglobin), lipid profiles, hsCRP, and brachial ankle pulse wave velocity (baPWV) were measured.ResultsSubjects with metabolic syndrome (n = 200) had higher baPWV than in subjects without metabolic syndrome (n = 401) even after adjustments for age, sex and presence of hypertension (1435.9 ± 212.2 vs. 1336.5 ± 225.0 cm/sec, p < 0.001). The differences of baPWV among normal FBS, prediabetes and diabetes mellitus groups are significant (P for trend = 0.036) by multivariate analysis (adjustments for age, sex, office systolic blood pressure). Subjects with diabetes mellitus (n = 30) had higher baPWV than in subjects with normal FBS (n = 384, 1525 ± 267.1 vs. 1341.5 ± 224.1 cm/sec, P = 0.016 adjustments for age, sex, office systolic blood pressure). BaPWV in subjects with prediabetes (n = 187) was slightly higher, but not statistically significant than in subjects with normal FBS (P = 0.377). Of interest, FBS was one of the independent predictors for increased baPWV (β = 0.809, 95 % CI 0.222-1.397, p = 0.007) by multivariate analysis.ConclusionsSubjects with abnormal metabolic conditions have increased arterial stiffness independent of age and BP which may contribute to the development of cardiovascular disease.

show abstract

“…AS may predict major adverse cardiac events (MACEs), a high-risk coronary plaque may progress rapidly and result in acute coronary syndrome [5]. Coronary computed tomography angiography (CCTA) can not only effectively evaluate the degree of coronary artery stenosis, but also analyze the coronary atherosclerotic plaque characteristics to identify high-risk plaques, which has unique advantages compared to other examinations [6].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of high-risk coronary plaques in patients with and without metabolic syndrome and the relationship with prognosis

Luo

Han

et al. 2020

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background: Metabolic syndrome (MS) is a disorder, characterized by clusters of cardiovascular risk factors such as central obesity, insulin resistance, dyslipidemia and hypertension. Patients with MS may have a higher plaque burden that increases their risk of major adverse cardiovascular events (MACEs). This study aimed to analyze the prevalence of high-risk coronary plaques in patients with and without MS by coronary computed tomography angiography (CCTA) and to investigate the relationship between MS, high-risk coronary plaques, and their prognosis. Methods: This was a retrospective cohort study of 1136 patients who underwent CCTA due to chest pain without obstructive heart disease (≥50% coronary stenosis) between January 2014 and December 2015 in our hospital. The relationships between high risk coronary plaques, MS, and other clinical factors were assessed. Multicollinearity analysis was performed to identify the collinearity between the variables. The proportional hazard assumption was checked and using Schoenfeld residual test. Cox proportional hazards model and Kaplan-Meier survival analysis assessed the relationship between MS, high-risk coronary plaques and MACEs.Results: High-risk plaques were more frequent in the MS group than non-MS group (P = 0.004). MS (HR = 2.128, 95%CI: 1.524-2.970, P < 0.001), presence of high-risk plaques (HR = 11.059, 95%CI: 7.749-57.232, P < 0.001) and high sensitivity C-reactive protein (hsCRP) (HR = 1.629, 95%CI: 1.128-2.352, P = 0.009) were related with an increased risk of MACEs in patients with risk factors for coronary heart disease. In patients with high-risk plaques, MS (HR = 2.265, 95%CI: 1.629-3.150, P < 0.001) and hsCRP (HR = 1.267, 95%CI: 1.191-1.348, P = 0.004) were related with an increased risk of MACEs. Kaplan-Meier analysis showed differences in MACEs between the MS and non-MS groups in the whole population and those with high-risk plaques (both P < 0.0001).Conclusions: High-risk plaques were more common in patients with MS. MS and the presence of high-risk plaques were independent risk factors for MACEs.

show abstract

The role of insulin resistance and metabolic risk factors on culprit coronary plaque

Cited by 6 publications

References 32 publications

Association Between Insulin Resistance and Coronary Plaque Vulnerability in Patients With Acute Coronary Syndromes: Insights From Optical Coherence Tomography

Association Between Insulin Resistance and Coronary Plaque Vulnerability in Patients With Acute Coronary Syndromes: Insights From Optical Coherence Tomography

The role of abnormal metabolic conditions on arterial stiffness in healthy subjects with no drug treatment

Prevalence of high-risk coronary plaques in patients with and without metabolic syndrome and the relationship with prognosis

Contact Info

Product

Resources

About