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Insulin Resistance Predicts Severity of Coronary Atherosclerotic Disease in Non-Diabetic Patients

Background: Insulin resistance (IR) in patients with type 2 diabetes mellitus (T2DM) represents a predictor of coronary artery disease (CAD). However, how IR is able to impact the severity of coronary atherosclerosis in non-diabetic patients is unknown. Objectives. We investigated the relation betwe...

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Autores principales: Strisciuglio, Teresa, Izzo, Raffaele, Barbato, Emanuele, Di Gioia, Giuseppe, Colaiori, Iginio, Fiordelisi, Antonella, Morisco, Carmine, Bartunek, Jozef, Franco, Danilo, Ammirati, Giuseppe, Pergola, Valerio, Imparato, Livio, Trimarco, Bruno, Esposito, Giovanni, Rapacciuolo, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408744/
https://www.ncbi.nlm.nih.gov/pubmed/32646007
http://dx.doi.org/10.3390/jcm9072144
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author Strisciuglio, Teresa
Izzo, Raffaele
Barbato, Emanuele
Di Gioia, Giuseppe
Colaiori, Iginio
Fiordelisi, Antonella
Morisco, Carmine
Bartunek, Jozef
Franco, Danilo
Ammirati, Giuseppe
Pergola, Valerio
Imparato, Livio
Trimarco, Bruno
Esposito, Giovanni
Rapacciuolo, Antonio
author_facet Strisciuglio, Teresa
Izzo, Raffaele
Barbato, Emanuele
Di Gioia, Giuseppe
Colaiori, Iginio
Fiordelisi, Antonella
Morisco, Carmine
Bartunek, Jozef
Franco, Danilo
Ammirati, Giuseppe
Pergola, Valerio
Imparato, Livio
Trimarco, Bruno
Esposito, Giovanni
Rapacciuolo, Antonio
author_sort Strisciuglio, Teresa
collection PubMed
description Background: Insulin resistance (IR) in patients with type 2 diabetes mellitus (T2DM) represents a predictor of coronary artery disease (CAD). However, how IR is able to impact the severity of coronary atherosclerosis in non-diabetic patients is unknown. Objectives. We investigated the relation between the IR and the extent and severity of coronary atherosclerosis in non-diabetic patients referred to coronary angiography (CA) Methods: Consecutive patients undergoing to CA for acute coronary syndromes or stable angina were analyzed. The IR was assessed by mean of the homeostasis model assessment of insulin resistance (HOMA-IR) whereas the SYNTAX score (SS) was used as index of the severity of coronary atherosclerosis Results: Overall, 126 patients were included, with a median SS of 12 (IQR 5.25–20.5). Patients were divided in four groups according to the distribution in quartiles of SS (SS1-2-3-4). A significant correlation between HOMA-IR and SS was observed, especially in women. A progressive increase of HOMA-IR was observed in parallel with the increasing severity (from SS1 to SS4) and extension (1-2-3-vessel disease) of coronary atherosclerosis. Multivariable analysis showed that the HOMA-IR was the strongest independent predictor of severe (SS4) and extensive (three-vessel disease) coronary atherosclerosis. Conclusion: Insulin resistance goes hand in hand with the extension and severity of coronary atherosclerosis in non-diabetic patients. The HOMA index is an independent predictor of three-vessel disease at CA. The HOMA index could be useful for risk stratification of CAD even in absence of T2DM.
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spelling pubmed-74087442020-08-13 Insulin Resistance Predicts Severity of Coronary Atherosclerotic Disease in Non-Diabetic Patients Strisciuglio, Teresa Izzo, Raffaele Barbato, Emanuele Di Gioia, Giuseppe Colaiori, Iginio Fiordelisi, Antonella Morisco, Carmine Bartunek, Jozef Franco, Danilo Ammirati, Giuseppe Pergola, Valerio Imparato, Livio Trimarco, Bruno Esposito, Giovanni Rapacciuolo, Antonio J Clin Med Article Background: Insulin resistance (IR) in patients with type 2 diabetes mellitus (T2DM) represents a predictor of coronary artery disease (CAD). However, how IR is able to impact the severity of coronary atherosclerosis in non-diabetic patients is unknown. Objectives. We investigated the relation between the IR and the extent and severity of coronary atherosclerosis in non-diabetic patients referred to coronary angiography (CA) Methods: Consecutive patients undergoing to CA for acute coronary syndromes or stable angina were analyzed. The IR was assessed by mean of the homeostasis model assessment of insulin resistance (HOMA-IR) whereas the SYNTAX score (SS) was used as index of the severity of coronary atherosclerosis Results: Overall, 126 patients were included, with a median SS of 12 (IQR 5.25–20.5). Patients were divided in four groups according to the distribution in quartiles of SS (SS1-2-3-4). A significant correlation between HOMA-IR and SS was observed, especially in women. A progressive increase of HOMA-IR was observed in parallel with the increasing severity (from SS1 to SS4) and extension (1-2-3-vessel disease) of coronary atherosclerosis. Multivariable analysis showed that the HOMA-IR was the strongest independent predictor of severe (SS4) and extensive (three-vessel disease) coronary atherosclerosis. Conclusion: Insulin resistance goes hand in hand with the extension and severity of coronary atherosclerosis in non-diabetic patients. The HOMA index is an independent predictor of three-vessel disease at CA. The HOMA index could be useful for risk stratification of CAD even in absence of T2DM. MDPI 2020-07-07 /pmc/articles/PMC7408744/ /pubmed/32646007 http://dx.doi.org/10.3390/jcm9072144 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Strisciuglio, Teresa
Izzo, Raffaele
Barbato, Emanuele
Di Gioia, Giuseppe
Colaiori, Iginio
Fiordelisi, Antonella
Morisco, Carmine
Bartunek, Jozef
Franco, Danilo
Ammirati, Giuseppe
Pergola, Valerio
Imparato, Livio
Trimarco, Bruno
Esposito, Giovanni
Rapacciuolo, Antonio
Insulin Resistance Predicts Severity of Coronary Atherosclerotic Disease in Non-Diabetic Patients
title Insulin Resistance Predicts Severity of Coronary Atherosclerotic Disease in Non-Diabetic Patients
title_full Insulin Resistance Predicts Severity of Coronary Atherosclerotic Disease in Non-Diabetic Patients
title_fullStr Insulin Resistance Predicts Severity of Coronary Atherosclerotic Disease in Non-Diabetic Patients
title_full_unstemmed Insulin Resistance Predicts Severity of Coronary Atherosclerotic Disease in Non-Diabetic Patients
title_short Insulin Resistance Predicts Severity of Coronary Atherosclerotic Disease in Non-Diabetic Patients
title_sort insulin resistance predicts severity of coronary atherosclerotic disease in non-diabetic patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408744/
https://www.ncbi.nlm.nih.gov/pubmed/32646007
http://dx.doi.org/10.3390/jcm9072144
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