Insulin resistance predicts the risk for recurrent coronary events in post-infarction patients

Szepietowska, Barbara; McNitt, Scott; Kutyifa, Valentina; Ryan, D. H.; Corsetti, James P.; Sparks, Charles E.; Moss, Arthur J.; Zaręba, Wojciech

doi:10.5603/cj.a2015.0014

Cited by 4 publications

(5 citation statements)

References 33 publications

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“…The patients who survive a mild MI need preventive care for heart failure and treatment for the long-term metabolic alterations, including development of IR and IGT, caused by MI [ 5 , 7 , 8 , 10 – 15 ]. In fact, abnormal glucose tolerance is an independent predictor of cardiovascular events such as recurrent MI, stroke, adverse cardiac remodeling, and heart failure during a median follow-up time up to 34 months post MI [ 18 , 45 – 47 ]. Similar to what is observed in humans [ 13 ], we show that mild MI led to progressive glucose intolerance in obese mice.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, IR, IGT, and dysglycemia may also contribute to the development of adverse LV remodeling post-MI [ 14 , 16 ] which is recognized as the predominant pathological process in the development of heart failure [ 17 ]. Furthermore, studies have shown direct association between IR, IGT, type 2 diabetes, and increased risk of subsequent MIs and the development of heart failure post-MI [ 11 , 12 , 18 ]. Thus, new therapeutic strategies to reduce the risk of MI-induced insulin resistance, glucose intolerance, and type 2 diabetes are essential to improve life expectancy and quality of life in patients who suffer from MI.…”

Section: Introductionmentioning

confidence: 99%

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Brown adipose tissue prevents glucose intolerance and cardiac remodeling in high-fat-fed mice after a mild myocardial infarction

et al. 2021

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Background Obesity increases the risk of developing impaired glucose tolerance (IGT) and type 2 diabetes (T2D) after myocardial infarction (MI). Brown adipose tissue (BAT) is important to combat obesity and T2D, and increasing BAT mass by transplantation improves glucose metabolism and cardiac function. The objective of this study was to determine if BAT had a protective effect on glucose tolerance and cardiac function in high-fat diet (HFD) fed mice subjected to a mild MI. Methods Male C57BL/6 mice were fed a HFD for eight weeks and then divided into Sham (Sham-operated) and +BAT (mice receiving 0.1 g BAT into their visceral cavity). Sixteen weeks post-transplantation, mice were further subdivided into ±MI (Sham; Sham-MI; +BAT; +BAT-MI) and maintained on a HFD. Cardiac (echocardiography) and metabolic function (glucose and insulin tolerance tests, body composition and exercise tolerance) were assessed throughout 22 weeks post-MI. Quantitative PCR (qPCR) was performed to determine the expression of genes related to metabolic function of perigonadal adipose tissue (pgWAT), subcutaneous white adipose tissue (scWAT), liver, heart, tibialis anterior skeletal muscle (TA); and BAT. Results +BAT prevented the increase in left ventricle mass (LVM) and exercise intolerance in response to MI. Similar to what is observed in humans, Sham-MI mice developed IGT post-MI, but this was negated in +BAT-MI mice. IGT was independent of changes in body composition. Genes involved in inflammation, insulin resistance, and metabolism were significantly altered in pgWAT, scWAT, and liver in Sham-MI mice compared to all other groups. Conclusions BAT transplantation prevents IGT, the increase in LVM, and exercise intolerance following MI. MI alters the expression of several metabolic-related genes in WAT and liver in Sham-MI mice, suggesting that these tissues may contribute to the impaired metabolic response. Increasing BAT may be an important intervention to prevent the development of IGT or T2D and cardiac remodeling in obese patients post-MI.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Brown adipose tissue prevents glucose intolerance and cardiac remodeling in high-fat-fed mice after a mild myocardial infarction

et al. 2021

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“…HOMA2-IR may be used to stratify risk for the recurrence of coronary events in the postinfarction population [ 32 ] and predict in-hospital mortality after acute coronary syndrome. [ 33 , 34 ] Previous studies have shown the incidence of adverse cardiac events including mortality rises independently from DM, along with the increase of IR in patients with coronary heart disease.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of glucose metabolism for non-ST-segment elevation infarction patients with diabetes mellitus and single concomitant chronic total occlusion following primary percutaneous coronary intervention

Xing

Zhang²,

Liu³

et al. 2017

Medicine

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Glucose metabolism status may play a predictive role in the severity of the complications among patients with type 2 diabetes mellitus (DM). However, few studies have focused on the prognostic value of glycosylated hemoglobin (HbA1c) and Homeostatic Model Assessment 2 for Insulin Resistance (HOMA2-IR) in patients with DM, non-ST-segment elevation infarction (NSTEMI), and single concomitant chronic total occlusion (CTO) following primary percutaneous coronary intervention (PCI). Short- and long-term prognostic value of HbA1c and HOMA2-IR in patients with DM with NSTEMI and single CTO who received primary percutaneous transluminal coronary intervention (pPCI).Data from 202 patients with NSTEMI and single CTO in nonculprit vessels were included. The incidence of revascularization, cardiogenic shock, ischemic stroke, major bleeding (ie, cerebral hemorrhage or massive hemorrhage of gastrointestinal tract), and cardiac death were combined as composite end points (CEPs). HbA1c was measured on admission and at 12 and 24 weeks after discharge. HOMA2-IR was measured on admission and at 6 and 12 weeks after discharge. The mean value of HbA1c and HOMA2-IR was calculated to determine the impact on 2.5-year CEPs. All patients were assessed during hospitalization and followed for up to 2.5 years after discharge.Mean age was 62.4 ± 11.8 years and 76% were male. Previous MI, lower left ventricular ejection fraction, and higher HbA1c (hazard ratio [HR] = 1.216; 95% confidence interval [CI] = 1.023–1.445; P = .023) were independently associated with a poor prognosis at 2.5 years. Higher HbA1c and HOMA2-IR on admission was associated with CEPs during hospitalization. Mean HOMA2-IR prior to pPCI was associated with revascularization (HR = 1.129; 95% CI = 1.008–1.265; P = .036) and ischemic stroke (HR = 1.276; 95% CI = 1.044–1.560; P = .017) during the 2.5 years follow-up period.Glucose metabolism status reflected by HbA1c and HOMA2-IR may provide prognostic value to patients with NSTEMI, type 2 DM, and single concomitant CTO following PCI. Therefore, patients with NSTEMI, CTO, and poor glycemic control should be carefully evaluated prior to PCI.

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“…В недавнем исследовании Iguchi et al был применен метод оптической когерентной томографии, позволяющий детально охарактеризовать структуру атеросклеротической бляшки: было показано, что инсулинорезистентность тесно взаимосвязана с большей склонностью атеросклеротической бляшки к тромбообразованию, что проявлялось меньшей толщиной фиброзной оболочки, большим содержанием липидов в бляшке у группы обследованных лиц с наибольшей выраженностью инсулинорезистентности [9]. В проспективных наблюдениях больных, перенесших острый коронарный синдром, обнаружено, что инсулинорезистентность была сопряжена со значительно худшим прогнозом [10], а также с развитием повторных острых коронарных синдромов [11]. Представляется важным подчеркнуть, что инсулинорезистентность способствует возрастанию риска рестеноза стентов, как было показано в недавнем проспективном исследовании 417 больных, которым было проведено стентирование с помощью DES [12].…”

Section: рис 1 содержание инсулина в плазме крови натощак и через 2unclassified

Уровень Инсулина В Плазме Крови У Больных Ишемической Болезнью Сердца В Зависимости От Выраженности Атеросклеротического Поражения Коронарных Сосудов

Mankovskii¹,

Stepura²

2017

ujcvs

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Цель работы – изучение содержание инсулина в крови у пациентов с ишемической болезнью сердца (ИБС) в зависимости от количества пораженных коронарных артерий. Материалы и методы. Обследовано 78 больных с ИБС без указаний на наличие явного сахарного диабета (СД) 2 типа или нарушения толерантности к глюкозе. Всем больным был проведен нагрузочный тест, коронаровентрикулография, а также пероральный тест на толерантность к глюкозе. Забор крови из вены проводился натощак и через 2 часа после употребления глюкозы. В каждом из полученных образцов крови проводилось определение содержания глюкозы и инсулина в плазме крови. Инсулин определяли иммуносорбентным анализом (ELISA). Результаты и обсуждение. Все обследованные лица были распределены на 3 группы в зависимости от количества пораженных сосудов. У обследованных пациентов с ИБС не было СД 2 типа или нарушения толерантности к глюкозе (преддиабета или латентного СД). Так, средний уровень гликемии натощак составил 6,31±0,21 ммоль/л, 5,78±0,15 ммоль/л и 5,74±0,26 ммоль/л, а через 2 часа после приема глюкозы гликемия была 8,15±0,60 ммоль/л, 8,56±0,47 ммоль/л, 7,26±0,61 ммоль/л у пациентов с поражением 1, 2 или 3 коронарных сосудов соответственно, р>0,05 при сравнении показателей между группами. Также не было выявлено повышения уровня гликозилированного гемоглобина или достоверных различий между тремя обследованными группами пациентов. Выявлено статистически значимое возрастание содержания инсулина в плазме крови у больных с ИБС, у которых атеросклеротическое поражение охватывало два или три коронарных сосуда по сравнению с пациентами, у которых стеноз был локализован в рамках только одной венечной артерии сердца. Выводы. Гиперинсулинемия, представляющая собой отражение инсулинорезистентности, взаимосвязана с более выраженным, ангиографически документированным атеросклеротическим поражением коронарных сосудов у больных с ИБС.

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Insulin resistance predicts the risk for recurrent coronary events in post-infarction patients

Cited by 4 publications

References 33 publications

Brown adipose tissue prevents glucose intolerance and cardiac remodeling in high-fat-fed mice after a mild myocardial infarction

Brown adipose tissue prevents glucose intolerance and cardiac remodeling in high-fat-fed mice after a mild myocardial infarction

Prognostic value of glucose metabolism for non-ST-segment elevation infarction patients with diabetes mellitus and single concomitant chronic total occlusion following primary percutaneous coronary intervention

Уровень Инсулина В Плазме Крови У Больных Ишемической Болезнью Сердца В Зависимости От Выраженности Атеросклеротического Поражения Коронарных Сосудов

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