High insulin resistance (HOMA-IR >2.50) was an independent predictor for the presence of thin-cap fibroatheroma in patients undergoing PCI (OR 3.57; 95% CI 1.42-9.55; P=0.007).
Observational (n=155)
Is insulin resistance associated with vulnerable coronary plaque characteristics identified by OCT in patients undergoing PCI?
Higher insulin resistance is independently associated with vulnerable coronary plaque characteristics, including thin-cap fibroatheroma, in patients undergoing PCI.
Effect estimate: OR 3.57 (95% CI 1.42-9.55)
Absolute Event Rate: 50% vs 26%
p-value: p=0.007
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 AND RESULTS: 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 (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.
Iguchi et al. (Mon,) conducted a observational in Patients undergoing percutaneous coronary intervention (n=155). High insulin resistance (HOMA-IR >2.5) vs. Lower insulin resistance (HOMA-IR <1.4) was evaluated on Presence of thin-cap fibroatheroma (TCFA) (OR 3.57, 95% CI 1.42-9.55, p=0.007). High insulin resistance (HOMA-IR >2.50) was an independent predictor for the presence of thin-cap fibroatheroma in patients undergoing PCI (OR 3.57; 95% CI 1.42-9.55; P=0.007).