Abstract 14006: Impact of Insulin Resistance on Post-proccedural Myocardial Injury and Clinical Outcomes in Patiens Underwent Elective Coronary Intervention with Drug-Eluting Stent
Background: Insulin resistance increases risk of cardiovascular event. However association between insulin resistance and clinical outcome after coronary intervention is unclear. The aim of this study is to evaluate association between homeostatic indices of insulin resistance (HOMA-IR) and post-procedural myocardial injury and clinical outcome after PCI with drug-eluting stent (DES).
Methods: We evaluated 516 consecutive patients who underwent elective PCI with DES and evaluation of insulin resistance. Diabetic patients receiving insulin therapy were excluded. Blood samples were collected from venous blood after overnight fasting, and fasting plasma glucose and insulin were measured. HOMA-IR was calculated according to the homeostasis model assessment. 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, MI and any revascularization.
Results: With increasing tertiles of HOMA-IR, post-procedural TnT and CK-MB increased. In multiple regression analysis, HOMA-IR independently associated with TnT elevation (Figure A). During a median follw-up of 623 days, patients with higest tertile of HOMA-IR are at the highest risk of cardiovascular events (Figure B). The incidence of stent thrombosis was not associated with HOMA-IR. The Cox proportional hazard models identified HOMA-IR to be independently associated with worse clinical outcome after PCI.
Conclusions: These results indicated an impact of insulin resistance on post-procedural cardiac biomarkers and worse clinical outcome after elective PCI even in patient treated with DES deployment.
- © 2010 by American Heart Association, Inc.