Insulin resistance is associated with coronary plaque vulnerability: insight from optical coherence tomography analysis.
Eur Heart J Cardiovasc Imaging
; 15(3): 284-91, 2014 Mar.
Article
en En
| MEDLINE
| ID: mdl-24022065
ABSTRACT
AIMS:
Previous studies have reported that insulin resistance plays an important role in the progression of atherosclerosis. However, the relationship between insulin resistance and coronary plaque instability is not well established. The purpose of this study was to assess the relationship between insulin resistance and coronary plaque characteristics identified by optical coherence tomography (OCT). METHODS ANDRESULTS:
This study enrolled 155 consecutive patients undergoing percutaneous coronary intervention. OCT image acquisitions were performed in the culprit lesions. Insulin resistance was identified using the homeostasis model assessment of insulin resistance (HOMA-IR). Subjects were divided into three tertiles according to the HOMA-IR values. Patients in the higher HOMA tertile had more frequent prevalence of lipid-rich plaques than those in the middle and lower tertiles (83 vs. 62 vs. 57%; P = 0.01). The thin-cap fibroatheroma (TCFA) prevalence rates among the higher (>2.5), middle (1.4-2.5), and lower HOMA-IR (<1.4) tertiles were 50, 29, and 26% (P = 0.02). The microvessel prevalence rates of the three tertiles were 54, 39, and 28% (P = 0.02). Furthermore, in the higher HOMA-IR group, the fibrous cap was significantly thinner compared with the other two tertiles (vs. lower HOMA-IR, P = 0.009; vs. middle HOMA-IR, P = 0.008). On multivariate analysis, acute coronary syndrome [odds ratio (OR) 17.98; 95% confidence interval (CI) 7.12-52.02; P < 0.0001] and HOMA-IR >2.50 (OR 3.57; 95% CI 1.42-9.55; P = 0.007) were independent predictors for the presence of TCFA.CONCLUSION:
This study suggests that insulin resistance might be associated with coronary plaque vulnerability.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
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Resistencia a la Insulina
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Tomografía de Coherencia Óptica
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Placa Aterosclerótica
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur Heart J Cardiovasc Imaging
Año:
2014
Tipo del documento:
Article
País de afiliación:
Japón