Usefulness of insulin resistance measured by homeostasis model assessment in predicting restenosis after coronary stent placement in nondiabetic patients

Sekiguchi, Makoto; Kurabayashi, Masahiko; Adachi, Hitoshi; Hara, Hiroshi; Oshima, Shigeru; Taniguchi, Koichi

doi:10.1016/j.amjcard.2003.12.036

Cited by 22 publications

(11 citation statements)

References 18 publications

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“…Our results agree with published data describing a relationship between greater neointimal index area (not measured with IVUS as in our study) and IR (16). Other studies also described a relationship between restenosis and IR, but in most of them diabetic patients were excluded and no IVUS measurements were performed (13,15,31). In the only published study in which diabetic patients were included and a direct relationship between plasma insulin levels and restenosis was described, IVUS was not used, and, unexpectedly, QCA parameters related to vessel diameter were not considered to be predictors of restenosis (14).…”

Section: Discussionsupporting

confidence: 82%

Predictors of restenosis after percutaneous coronary intervention using bare-metal stents: a comparison between patients with and without dysglycemia

Lima-Filho

Figueiredo

Foss‐Freitas

et al. 2010

Braz J Med Biol Res

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2.063 (RR = 0.44; 95%CI = 0.14-0.64; P = 0.027), and fasting plasma glucose (FPG): ≤108.8 mg/dL (RR = 0.53; 95%CI = 0.13-0.75; P = 0.046). SV was an independent predictor of restenosis by multivariable analysis. Dysglycemia is a common clinical condition in patients submitted to PCI. The degree of insulin resistance, FPG, RVD, SA, and SV were correlated with restenosis. SV was inversely correlated with an independent predictor of restenosis in patients treated with a bare-metal stent.]]>

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Section: Discussionsupporting

confidence: 82%

Predictors of restenosis after percutaneous coronary intervention using bare-metal stents: a comparison between patients with and without dysglycemia

Lima-Filho

Figueiredo

Foss‐Freitas

et al. 2010

Braz J Med Biol Res

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“…In addition, a role of IR in the development of restenosis after coronary stenting has also been suggested [63,64]. Therefore, this concept is analogous to the previously proposed hypothesis suggestive of the mechanisms other than ADMA being a correlate of more severe coronary atherosclerosis as an explanation of the well-recognized ability of ADMA to predict adverse outcome in CAD [7-10,14].…”

Section: Discussionsupporting

confidence: 52%

Differential associations of angiographic extent and severity of coronary artery disease with asymmetric dimethylarginine but not insulin resistance in non-diabetic men with stable angina: a cross-sectional study

Kruszelnicka

Surdacki

Golay³

2013

Cardiovasc Diabetol

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BackgroundAsymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthesis inhibitor, and insulin resistance (IR) have been implicated in atherogenesis. Our aim was to estimate relations between ADMA, the magnitude of IR and angiographic indices of extent and severity of coronary atherosclerosis in non-diabetic men with stable coronary artery disease (CAD).MethodsWe studied 151 non-diabetic men (mean age 57 ± 11 years) with stable angina, obstructive CAD (at least 1 luminal diameter stenosis of ≥70% in major coronary segments) and without heart failure, and 34 age-matched controls free of ≥50% coronary narrowings. The following CAD indices were computed: the number of major epicardial vessels with ≥70% stenosis, Sullivan extent score representing a proportion of the visible coronary tree with vessel wall irregularities, and Gensini score which reflects both CAD severity and extent, yet assigning a heavier weight to proximal segments and to the more severe narrowings by a non-linear point system. An estimate of IR was derived by homeostasis model assessment (HOMA-IR) from fasting insulin and glucose.ResultsAmong the CAD patients, the proportions of subjects with 1-vessel, 2- vessel and 3-vessel CAD were 26%, 25% and 49%, respectively. ADMA levels were higher in patients with obstructive CAD compared to the controls (0.51 ± 0.10 vs. 0.46 ± 0.09 μmol/L [SD], P = 0.01), whereas HOMA-IR was similar (median, 3.2 [interquartile range: 2.4–4.9] vs. 2.9 [2.3–4.7], P = 0.2). Within the CAD group, ADMA increased across ascending quartiles of Sullivan score (Spearman’s rho = 0.23, P = 0.004), but not with Gensini score (rho = 0.12, P = 0.15) or the number of vessels involved (rho = 0.08, P = 0.3). ADMA correlated to log-transformed Sullivan score (Pearson's r = 0.21, P = 0.008), which was only slightly attenuated upon multivariate adjustment (β = 0.19 ± 0.08 [SEM], P = 0.015). HOMA-IR did not differ according to any measure of angiographic CAD (P ≥ 0.2). ADMA and log (HOMA-IR) were mutually unrelated (r = 0.07, P = 0.4).ConclusionsADMA is associated with diffuse but not focal coronary atherosclerosis in non-diabetic men with stable CAD irrespectively of the degree of IR. The independent relationship between ADMA and coronary atherosclerotic burden may contribute to the well-recognized prognostic effect of ADMA in CAD.

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“…Furthermore, the incidence of atherosclerotic cardiovascular disease is increased in MS patients with normal glucose tolerance, where the number of diseased coronary arteries found by coronary angiography correlated independently with indices of insulin resistances [11]. Similarly, insulin resistance predicts restenosis after coronary artery stent placement in nondiabetic patients [12]. The incidence of acute ischemic events (myocardial infarction [MI], stroke or MI/stroke) is increased by the MS [8].…”

Section: Resultsmentioning

confidence: 98%

Metabolic syndrome may increase operative mortality in patients undergoing coronary artery bypass graft surgery

Tung¹,

Collard²,

Pan³

2008

Future Lipidology

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Evaluation of: Echahidi N, Pibarot P, Despres JP et al.: Metabolic syndrome increases operative mortality in patients undergoing coronary artery bypass grafting surgery. J. Am. Coll. Cardiol. 50(8), 843-851 (2007).Metabolic syndrome (MS) is associated with increased risk of coronary heart disease, stroke and cardiovascular mortality. However, little data exist on the relationship between MS and operative mortality following coronary revascularization. This retrospective study found that MS in patients undergoing coronary artery bypass graft (CABG) surgery is a significant independent predictor of an increased risk of post-operative mortality. Thus, MS may be an important and novel patient risk factor for CABG surgery.

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Usefulness of insulin resistance measured by homeostasis model assessment in predicting restenosis after coronary stent placement in nondiabetic patients

Cited by 22 publications

References 18 publications

Predictors of restenosis after percutaneous coronary intervention using bare-metal stents: a comparison between patients with and without dysglycemia

Predictors of restenosis after percutaneous coronary intervention using bare-metal stents: a comparison between patients with and without dysglycemia

Differential associations of angiographic extent and severity of coronary artery disease with asymmetric dimethylarginine but not insulin resistance in non-diabetic men with stable angina: a cross-sectional study

Metabolic syndrome may increase operative mortality in patients undergoing coronary artery bypass graft surgery

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