Abstract 12812: Association between Estimated GIR, Novel Marker of Insulin Sensitivity and Lipid-Rich Coronary Plaques: An Integrated Backscatter Intravascular Ultrasound (IB-IVUS) Analysis

Abstract

Background Insulin resistance is key pathologic factor of developing vulnerable coronary plaques. Recently, estimated glucose infusion rate (EGIR), novel index of insulin sensitivity instead of homeostasis model assessment of insulin resistance (HOMA-IR), was proposed (J Diabetes Invest 2011; 2:140-146). The aim of the present study is to evaluate association between EGIR and coronary plaque characteristics measured by IB-IVUS. Methods Total of 110 patients with stable angina who underwent elective coronary intervention were enrolled. EGIR was estimate using following equation as: EGIR = 25.772-0.101× west circumference - 9.444 × log Triglyceride / log HDL-cholestrol. Color coded maps of tissue characteristics of each 1mm slice in target lesions were constructed. Volume of each plaque components (calcification, fibrous and lipid core), percentage of lipid volume (% LV; volume of lipid core / total plaque volume) was calculated. We defined lipid-rich plaque (LRP) as plaque with %lipid more than 61.1% which was 75th percentile of %LV. Results In linear regression analysis, logEGIR significantly correlated with %LV (r = -0.26, p < 0.01) in target lesion. We found no significant association between %LV and other clinical factor including HOMA-IR. In logistic regression analysis, EGIR found to be only independent predictor of LRP after adjusting for conventional risk factors( Table ). Conclusions These results demonstrated potential role of EGIR to identify high-risk patient with lipid-rich coronary lesions.