Loading...
Please wait, while we are loading the content...
Similar Documents
Impact of Insulin Resistance on Acetylcholine-Induced Coronary Artery Spasm in Non-Diabetic Patients
| Content Provider | Semantic Scholar |
|---|---|
| Author | Kang, Kwan Woo Choi, Byoung Geol Rha, Seung Woon |
| Copyright Year | 2018 |
| Abstract | PURPOSE Coronary artery spasm (CAS) and diabetes mellitus (DM) are implicated in endothelial dysfunction, and insulin resistance (IR) is a major etiological cause of type 2 DM. However, the association between CAS and IR in non-diabetic individuals has not been elucidated. The aim of the present study was to evaluate the impact of IR on CAS in patients without DM. MATERIALS AND METHODS A total of 330 eligible patients without DM and coronary artery disease who underwent acetylcholine (Ach) provocation test were enrolled in this study. Inclusion criteria included both hemoglobin A1c <6.0% and fasting glucose level <110 mg/dL without type 2 DM. Patients were divided into quartile groups according the level of homeostasis model assessment of insulin resistance (HOMA-IR): 1Q (n=82; HOMA-IR<1.35), 2Q (n=82; 1.35≤HOMA-IR<1.93), 3Q (n=83; 1.93≤HOMA-IR< 2.73), and 4Q (n=83; HOMA-IR≥2.73). RESULTS In the present study, the higher HOMA-IR group (3Q and 4Q) was older and had higher body mass index, fasting blood glucose, serum insulin, hemoglobin A1c, total cholesterol, and triglyceride levels than the lower HOMA-IR group (1Q). Also, poor IR (3Q and 4Q) was considerably associated with frequent CAS. Compared with Q1, the hazard ratios for Q3 and Q4 were 3.55 (95% CI: 1.79-7.03, p<0.001) and 2.12 (95% CI: 1.07-4.21, p=0.031), respectively, after adjustment of baseline risk confounders. Also, diffuse spasm and accompanying chest pain during Ach test were more strongly associated with IR patients with CAS. CONCLUSION HOMA-IR was significantly negatively correlated with reference diameter measured after nitroglycerin and significantly positively correlated with diffuse spasm and chest pain. |
| Starting Page | 1057 |
| Ending Page | 1063 |
| Page Count | 7 |
| File Format | PDF HTM / HTML |
| PubMed reference number | 30328320v1 |
| Alternate Webpage(s) | https://doi.org/10.3349/ymj.2018.59.9.1057 |
| DOI | 10.3349/ymj.2018.59.9.1057 |
| Journal | Yonsei medical journal |
| Volume Number | 59 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Acetylcholine Arteriopathic disease Body mass index Chest Pain Cholesterol Coronary Artery Disease Diabetes Mellitus Diameter (qualifier value) Glucose Hematological Disease Insulin Resistance Nitroglycerin Patients Spasm Triglycerides |
| Content Type | Text |
| Resource Type | Article |
