Abstract 1931: Impact of Insulin Resistance on Elevation of Post-procedural Cardiac Biomarker and Long-term Clinical Outcomes in Patients Underwent Elective Coronary Intervention
Background: Recently, some trials demonstrated that the presence of insulin resistance and metabolic syndrome was associated with short-term and long-term outcomes after percutaneous coronary intervention (PCI). The aim of this study is to evaluate potential association between homeostatic indices of insulin resistance (HOMA-IR) and post-procedural myocardial injury and clinical outcome after PCI.
Methods: From January 2005 to December 2006, 230 consecutive patients who underwent elective stent implantations and evaluation of insulin resistance were enrolled in this study. Blood samples were collected from venous blood after overnight fasting. HOMA-IR was calculated according to the homeostasis model assessment as follows: HOMA-IR = fasting glucose (mg/dL) × fasting insulin (mU/L)/405. Patients were divided into two groups according 50 percentile (2.11) for HOMA-IR. Post-procedural myocardial injury was evaluated by analysis of troponin-T(TnT)and CK-MB 18 hours after PCI. Cardiac event was defined as the composite end-point of death of any cause, MI and revascularization of new lesion.
Results: Post-procedural TnT and CK-MB were significantly higher in patients with higher HOMA-IR compared to those with lower HOMA-IR(0.05±0.09 vs 0.15±0.40, p<0.01 and 14.8±6.5 vs 19.9±20.7, p<0.05, respectively). Multivariate linear regression analysis demonstrated that HOMA-IR independently correlated with TnT. In Kaplan-Meier analyses, higher HOMA-IR was associated with worse clinical outcomes (Figure⇓).
Conclusions: These results indicated an impact of insulin resistance on post-procedural cardiac biomarkers and worse clinical outcome after elective PCI.