Impact of insulin resistance on 1-year clinical outcomes in non-diabetic patients undergoing percutaneous coronary intervention with drug-eluting stents

J Cardiol. 2013 Feb;61(2):113-6. doi: 10.1016/j.jjcc.2012.08.022. Epub 2012 Nov 16.

Abstract

Background: Insulin resistance (IR) is known to be a risk factor for coronary artery disease (CAD). We aimed to evaluate the impact of IR on 1-year clinical outcomes in non-diabetic CAD patients who underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DESs).

Methods and results: A total of 229 consecutive non-diabetic CAD patients treated with DESs were enrolled. Study population was divided into IR group [homeostasis model assessment (HOMA) index ≥ 2.5, n=54] and non-IR group (HOMA index<2.5, n=175). Baseline clinical and procedural characteristics were similar between the groups except higher incidence of high-sensitivity C-reactive protein and lower incidence of multivessel disease as the target vessel in the non-IR group. There was a trend toward longer restenosis lesion length in the IR group at 6 months angiographic follow up but composite major clinical outcomes up to 1 year were similar between the two groups.

Conclusions: Despite worse trend in angiographic outcomes in the IR group (HOMA index ≥ 2.5), it was not translated into worse 1-year major clinical outcomes following PCI with DESs as compared to the non-IR group.

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary / adverse effects*
  • Angioplasty, Balloon, Coronary / mortality
  • Coronary Angiography
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / surgery*
  • Coronary Restenosis / diagnostic imaging
  • Coronary Restenosis / mortality
  • Coronary Restenosis / pathology
  • Drug-Eluting Stents*
  • Fasting / blood
  • Female
  • Humans
  • Insulin / blood
  • Insulin Resistance / physiology*
  • Male
  • Middle Aged
  • Republic of Korea
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Insulin