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Insulin resistance predicts progression of de novo atherosclerotic plaques in patients with coronary heart disease: a one-year follow-up study Full Text
Cardiovascular Diabetology, 06/25/2012

An X et al. – Insulin resistance is an independent predictor of atherosclerosis plaque progression in patients with coronary heart disease in both the diabetic and non–diabetic population.

Methods
  • From June 7, 2007 to December 30, 2011, 366 patients received their index coronary angiogram and were subsequently found to have coronary atherosclerotic plaques or normal angiograms were consecutively enrolled in the study by the department of cardiology at the Ruijin Hospital, which is affiliated to the Shanghai Jiaotong University School of Medicine.
  • All patients had follow–up angiograms after the 1–year period for evaluating the progression of the coronary lesions.
  • The modified Gensini score was adopted for assessing coronary lesions while the HOMA–IR method was utilized for determining the state of their insulin resistance.
  • Baseline characteristics and laboratory test results were described and the binomial regression analysis was conducted to investigate the relationship between insulin resistance and coronary atherosclerotic plaque progression.

Results
  • Index and follow–up Gensini scores were similar between the higher insulin lower insulin resistant groups (9.09 +/– 14.33 vs 9.44 +/– 12.88, p = 0.813 and 17.21 +/– 18.46 vs 14.09 +/– 14.18, p =0.358).
  • However the Gensini score assessing coronary lesion progression between both visits was significantly elevated in the higher insulin resistant group (8.13 +/– 11.83 versus 4.65 +/– 7.58, p = 0.019).
  • Multivariate logistic binomial regression analysis revealed that insulin resistance (HOMA–IR > 3.4583) was an independent predictor for coronary arterial plaque progression (OR = 4.969, p = 0.011).
  • They also divided all the participants into a diabetic (n = 136) and a non–diabetic group (n = 230), and HOMA–IR remained an independent predictor for atherosclerosis plaque progression.

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