Liang-Ping Zhao1, Wei-Ting Xu, Li Wang, Hui Li, Chun-Lai Shao, Hai-Bo Gu, Siew-Pang Chan, Hai-Feng Xu, Xiang-Jun Yang. 1. aDepartment of Cardiology, The First Affiliated Hospital of Soochow University bDepartment of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, China cDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore dDepartment of Mathematics & Statistics, Faculty of Engineering, Technology & Science, La Trobe University, Melbourne, Victoria, Australia.
Abstract
OBJECTIVE: Previous studies have reported that insulin resistance is related to early in-stent restenosis (ISR) after coronary stenting. This study aimed to evaluate the influence of insulin resistance on the long-term angiographic outcome in patients undergoing coronary drug-eluting stent (DES) implantation. MATERIALS AND METHODS: Within a single hospital-based cohort of patients (n=529) who underwent coronary DES implantation, angiographic follow-up was performed successfully for 417 study patients at 12-48 months after coronary stenting. ISR was defined as stenosis of at least 50% of the luminal diameter. Fasting plasma glucose and fasting plasma insulin were measured. Insulin resistance was expressed by the homeostasis model assessment index (HOMA-IRI). RESULTS: Among the 417 patients who completed angiographic follow-up (mean 17.5±10.2 months), 58 patients (13.9%) had ISR whereas the remaining 359 patients (86.1%) did not have ISR. Patients with ISR had higher insulin resistance index (IRI) than nonrestenosis patients (P=0.004). Multiple logistic regression analysis (logit) showed that IRI was associated significantly with ISR (adjusted odds ratio 1.476, 95% confidence interval 1.227-1.776; P<0.001). In the nondiabetes subgroup of 309 patients, IRI was higher in patients with ISR than in nonrestenosis patients, as confirmed in a separate logit analysis (adjusted odds ratio 1.456, 95% confidence interval 1.152-1.839; P=0.002). Multiple linear regression analysis showed that IRI was associated significantly with in-stent diameter stenosis degree (P=0.043). CONCLUSION: Insulin resistance was associated with ISR in patients undergoing coronary DES implantation at long-term angiographic follow-up.
OBJECTIVE: Previous studies have reported that insulin resistance is related to early in-stent restenosis (ISR) after coronary stenting. This study aimed to evaluate the influence of insulin resistance on the long-term angiographic outcome in patients undergoing coronary drug-eluting stent (DES) implantation. MATERIALS AND METHODS: Within a single hospital-based cohort of patients (n=529) who underwent coronary DES implantation, angiographic follow-up was performed successfully for 417 study patients at 12-48 months after coronary stenting. ISR was defined as stenosis of at least 50% of the luminal diameter. Fasting plasma glucose and fasting plasma insulin were measured. Insulin resistance was expressed by the homeostasis model assessment index (HOMA-IRI). RESULTS: Among the 417 patients who completed angiographic follow-up (mean 17.5±10.2 months), 58 patients (13.9%) had ISR whereas the remaining 359 patients (86.1%) did not have ISR. Patients with ISR had higher insulin resistance index (IRI) than nonrestenosis patients (P=0.004). Multiple logistic regression analysis (logit) showed that IRI was associated significantly with ISR (adjusted odds ratio 1.476, 95% confidence interval 1.227-1.776; P<0.001). In the nondiabetes subgroup of 309 patients, IRI was higher in patients with ISR than in nonrestenosis patients, as confirmed in a separate logit analysis (adjusted odds ratio 1.456, 95% confidence interval 1.152-1.839; P=0.002). Multiple linear regression analysis showed that IRI was associated significantly with in-stent diameter stenosis degree (P=0.043). CONCLUSION:Insulin resistance was associated with ISR in patients undergoing coronary DES implantation at long-term angiographic follow-up.
Authors: Lu Liu; Jing Liu; Qun Gao; Yang Wu; Jinjin Lu; Jie Wan; Yan Li; Xiaoyun Cui; Kun Zhou; Wenhao Jia; Yanchao Huang; Wenbai Qu; Qian Lin Journal: Evid Based Complement Alternat Med Date: 2018-07-11 Impact factor: 2.629