Impact of insulin resistance on prognosis in non-diabetic patients with acute coronary syndromes / 中华心血管病杂志
Zhonghua xinxueguanbing zazhi
; (12): 559-562, 2013.
Article
en Zh
| WPRIM
| ID: wpr-261497
Biblioteca responsable:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the impact of insulin resistance (IR) on prognosis in non-diabetic acute coronary syndrome patients.</p><p><b>METHODS</b>In this prospective study, we enrolled 332 non-diabetic patients suffering from acute coronary syndrome. The patients were divided into three groups by HOMA-IR which calculated by formula: low HOMA-IR group (HOMA-IR < 2), 44 cases; moderate HOMA-IR group (2 ≤ HOMA2-IR < 6), 99 cases; high HOMA-IR group (HOMA ≥ 6) with HOMA index, 179 cases. The in-hospital medical records of patients were compared, and all patients were followed up for one year after discharge.</p><p><b>RESULTS</b>Incidence of hypertension (P = 0.013), dyslipidemia (P < 0.001), faster resting heart rate (P < 0.001) and number of triple vessel coronary artery disease (P = 0.017) in high HOMA-IR group were significantly higher than in low and moderate HOMA-IR group. During follow-up, the major end-point events increased in proportion to IR grade: 64.3% (26/44) in the high HOMA-IR group, 54.7% (52/99) in moderate HOMA-IR group and 41.3% (74/199) in low HOMA-IR group (P = 0.034). Multivariable logistic regression analysis showed that high sensitivity C reactive protein (OR = 1.012, 95%CI:1.002-1.022, P = 0.022), HOMA-IR (OR = 1.250, 95%CI:1.043-1.497, P = 0.015) , triple vessel coronary artery disease (OR = 5.914, 95%CI:2.947-11.868, P < 0.001) , ischemic changes on ECG (OR = 5.495, 95%CI:2.925-10.324, P < 0.001) and low left ventricular ejection fraction (LVEF ≤ 40%) (OR = 13.205, 95%CI:5.000-34.661, P < 0.001) were independent risk factor for major end-point events during follow-up.</p><p><b>CONCLUSIONS</b>Increased insulin resistance is linked with poor prognosis of non-diabetic patients with acute coronary syndrome.</p>
Texto completo:
1
Base de datos:
WPRIM
Asunto principal:
Pronóstico
/
Resistencia a la Insulina
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Modelos Logísticos
/
Estudios Prospectivos
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Estudios de Seguimiento
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Síndrome Coronario Agudo
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
Idioma:
Zh
Revista:
Zhonghua xinxueguanbing zazhi
Año:
2013
Tipo del documento:
Article