Key result
Higher insulin sensitivity via QUICKI links to lower CV mortality in revascularized ischemic cardiomyopathy.
Why the study?
The relevance of insulin resistance to post-revascularization remodeling and long-term outcomes in patients with ischemic injury remained unclear.
Does insulin sensitivity, as measured by QUICKI, predict ventricular remodeling and long-term cardiovascular mortality in patients with ischemic cardiomyopathy after revascularization?
Cohort (n=732)
No
Does insulin sensitivity, as measured by QUICKI, predict ventricular remodeling and long-term cardiovascular mortality in patients with ischemic cardiomyopathy after revascularization?
Insulin sensitivity, measured by the simple fasting-based QUICKI index, is a strong independent predictor of adverse ventricular remodeling and long-term cardiovascular mortality in patients with ischemic cardiomyopathy following revascularization.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for QUICKI use after revascularization in ischemic cardiomyopathy; leaves open prospective trials before practice change.
Introduction: Insulin resistance may influence myocardial recovery after ischemic injury, but its relevance to post-revascularization remodeling and long-term outcomes remains unclear. Methods: We examined 732 patients with ischemic cardiomyopathy who underwent revascularization and had complete metabolic and echocardiographic data, with a median follow-up of 8.1 years. Insulin sensitivity was assessed using the Quantitative Insulin Sensitivity Check Index (QUICKI). Ventricular remodeling was evaluated by changes in LVEDD and LVESD. Results: Across penalized regression and complementary machine-learning analyses, QUICKI consistently showed a stronger association with cardiovascular mortality than fasting glucose, insulin, or lipid measures. Lower QUICKI values were linked to greater ventricular dilatation, and these associations remained stable across analytic frameworks. Time-dependent ROC analysis demonstrated that QUICKI provided high early discriminatory performance for cardiovascular death. External validation in NHANES 2013-2016 further supported an inverse relationship between QUICKI and cardiovascular mortality risk. Discussion: These findings suggest that insulin sensitivity, captured by a simple fasting-based index, reflects a metabolic vulnerability that relates to both structural remodeling and long-term prognosis after revascularization, aligning with the metabolic dimension of the CKM framework and offering a potential addition to contemporary risk-stratification strategies.
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Tang et al. (2026) conducted a cohort in ischemic cardiomyopathy (n=732). Quantitative Insulin Sensitivity Check Index (QUICKI) vs. lower QUICKI values / conventional metabolic indicators was evaluated on cardiovascular death (β = 2.59). Higher insulin sensitivity, measured by QUICKI, was consistently associated with a lower risk of cardiovascular mortality and less ventricular dilatation in patients with ischemic cardiomyopathy after revascularization.
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