Document Detail


Impact of insulin resistance on post-procedural myocardial injury and clinical outcomes in patients who underwent elective coronary interventions with drug-eluting stents.
MedLine Citation:
PMID:  23174640     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study sought to evaluate the associations between homeostatic indexes of insulin resistance (HOMA-IR) and post-procedural myocardial injury and clinical outcome after a percutaneous coronary intervention (PCI) with a drug-eluting stent.
BACKGROUND: Insulin resistance increases the risk of cardiovascular events. However, the association between insulin resistance and clinical outcome after coronary intervention is unclear.
METHODS: We evaluated 516 consecutive patients who underwent elective PCI with drug-eluting stents. Blood samples were collected from venous blood after overnight fasting, and fasting plasma glucose and insulin levels were measured. HOMA-IR was calculated according to the homeostasis model assessment. Post-procedural myocardial injury was evaluated by analysis of troponin T and creatine kinase-myocardial band isozyme levels hours after PCI. Cardiac event was defined as the composite endpoint of cardiovascular death, myocardial infarction, and any revascularization.
RESULTS: With increasing tertiles of HOMA-IR, post-procedural troponin T and creatine kinase-myocardial band levels increased. In the multiple regression analysis, HOMA-IR was independently associated with troponin T elevation. During a median follow-up of 623 days, patients with the highest tertiles of HOMA-IR had the highest risk of cardiovascular events. The Cox proportional hazard models identified HOMA-IR as independently associated with worse clinical outcome after adjustment for clinical and procedural factors.
CONCLUSIONS: These results indicated the impact of insulin resistance on post-procedural myocardial injury and clinical outcome after elective PCI with drug-eluting stent deployment. Evaluation of insulin resistance may provide useful information for predicting clinical outcomes after elective PCI.
Authors:
Tadayuki Uetani; Tetsuya Amano; Kazuhiro Harada; Katsuhide Kitagawa; Ayako Kunimura; Yusaku Shimbo; Ken Harada; Tomohiro Yoshida; Bunichi Kato; Masataka Kato; Nobuyuki Marui; Michio Nanki; Nigishi Hotta; Hideki Ishii; Tatsuaki Matsubara; Toyoaki Murohara
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  5     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-23     Completed Date:  2013-07-01     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1159-67     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiomyopathies / etiology*
Drug-Eluting Stents*
Female
Humans
Insulin Resistance*
Male
Percutaneous Coronary Intervention*
Postoperative Complications / etiology*
Retrospective Studies
Surgical Procedures, Elective
Treatment Outcome
Comments/Corrections
Comment In:
JACC Cardiovasc Interv. 2012 Nov;5(11):1168-9   [PMID:  23174641 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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