Key result
Manifest insulin resistance was significantly more frequent in patients with slow coronary flow compared to those with normal coronary arteries (25% vs 3%, P=0.01).
Why the study?
Is slow coronary flow associated with increased insulin resistance in non-diabetic patients?
Case-Control (n=56)
No
Is slow coronary flow associated with increased insulin resistance in non-diabetic patients?
Absolute Event Rate: 25% vs 3%
p-value: p=0.01
Manifest insulin resistance is significantly more frequent in non-diabetic patients with slow coronary flow, suggesting a potential pathophysiological link between metabolic dysfunction and microvascular resistance.
No immediate practice change; hypothesis-generating for insulin resistance in slow coronary flow, needing prospective validation.
Introduction: In this study, we sought to determine whether insulin resistance, which is investigated by homeostatic modelling, is related to slow coronary flow (SCF). Materials and Methods: A total of 24 patients with SCF (4 females/20 males, mean age 47 ± 12 years) and 32 patients with normal coronary artery (10 females/22 males, mean age 52 ± 12 years) were included in the study. Baseline glucose, insulin and plasma lipid levels were measured. A standard oral glucose tolerance test (OGTT) was performed and post-challenge insulin levels were also measured. The index of insulin resistance was calculated with the homeostatic modelling [homeostatic model assessment for insulin resistance index (HOMA-IR)]. Results: There were no differences between the 2 groups with regard to age, lipid levels, blood pressure levels, history of smoking, fasting and post-challenge plasma glucose. Baseline insulin levels were augmented in the SCF group (9.64 ± 5.93 vs 7.04 ± 3.26, P = 0.041). HOMA-IR levels were not different between the study groups (2.20 ± 1.44 vs 1.69 ± 0.86, P = 0.129). Manifest insulin resistance was significantly higher in the CSF group as compared with the control group (25% vs 3%, P = 0.01). Conclusion: Manifest insulin resistance is seen more frequently in patients with SCF.
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Nurkalem et al. (2008) conducted a case-control in Slow coronary flow (n=56). Slow coronary flow vs. Normal coronary arteries was evaluated on Manifest insulin resistance (HOMA-IR > 3.5) (p=0.01). Manifest insulin resistance was significantly more frequent in patients with slow coronary flow compared to those with normal coronary arteries (25% vs 3%, P=0.01).
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