Abstract 17872: Differential Association of Insulin Resistance and Metabolic Syndrome with Acute Myocardial Infarction and All-cause Mortality in Older Adults
Background: Insulin resistance (IR) and metabolic syndrome (MetS) often coexist and both are considered risk factors for adverse cardiovascular (CV) outcomes. However, recent evidence suggests the association between IR and MetS may be more complex and mechanisms of their actions may vary. We examined the associations of MetS and IR with all-cause mortality and incident acute myocardial infarction (AMI) in older adults.
Methods: Of the 5795 community-dwelling adults ≥65 years in the Cardiovascular Health Study, 4475 had no coronary artery disease (CAD) and had data on baseline fasting serum glucose and insulin levels (those receiving insulin therapy were excluded) at baseline. MetS was defined using Adult Treatment Panel (ATP) III criteria and IR was estimated using homeostasis model assessment (HOMA) IR scores.
Results: Participants (n=4475) had a mean age 73 (±6) years, 61% were women and 15% African American. Incident AMI occurred in 12% and 10% of those with and without MetS and in 9%, 11% and 12% of those with HOMA-IR score tertiles 1 (n=1479), 2 (n=1495) and 3 (n=1501) respectively. Association of MetS and IR with incident AMI and death during >12 years of follow-up are displayed in the Table.
Conclusions: Among community-dwelling older adults free of baseline CAD, MetS was associated with incident AMI but not death and HOMA-IR in the highest tertile was associated with death but not incident AMI, independently of each other and other CV risk factors.
- © 2010 by American Heart Association, Inc.