Author + information
- Tomokazu Iguchi,
- Takao Hasegawa,
- Kenichiro Otsuka,
- Kenji Matsumoto,
- Shoichi Ehara,
- Akihisa Hanatani,
- Kenei Shimada and
- Minoru Yoshiyama
Relationship between insulin resistance (IR) and coronary plaque instability has not been well known. We sought to assess the association between IR and coronary plaque characteristics identified by optical coherence tomography (OCT).
This study enrolled consecutive 155 patients undergoing percutaneous coronary intervention. In the culprit lesions, we assessed lipid-rich plaque length and arc, fibrous cap thickness, frequency of thin-cap fibroatheroma (TCFA), thrombus, ruptured plaque, macrophage, and microvessel identified by OCT. IR was defined as the homeostasis model assessment of insulin resistance (HOMA-IR).
Patients in higher IR group (HOMA-IR >2.50, n = 52) had more frequently lipid-rich plaque than those in lower IR group (HOMA-IR ≤2.50, n = 103) (83% vs 59%, p = 0.004). Compared to lower IR group, higher IR group had significantly more frequently presence of TCFA (27% vs 50%, p = 0.005). In addition, fibrous cap thickness in higher IR group was significantly thinner than those in lower IR group (71.3 ± 29.2 µm vs 90.1 ± 39.6 µm, p = 0.008). On multivariate analysis, acute coronary syndrome (odds ratio; 17.98, 95% confidential interval [CI]; 7.12-52.02, p <0.0001) and HOMA-IR >2.50 (odds ratio; 3.57, 95% CI; 1.42-9.55, p = 0.007) were independent predictors for presence of TCFA (Table).
This study suggests that IR might be a contributing factor for the presence of vulnerable coronary plaque.
|Variable||Odds Ratio||95% Confidence Interval||p-value|
|Acute coronary syndrome||17.98||7.12–52.02||<0.0001|
|High sensitive C-reactive protein||0.58||0.02–19.67||0.75|
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: What's New with Risk Stratification in SIHD: Biomarkers, Genes and ECG
Abstract Category: 10. Chronic CAD/Stable Ischemic Heart Disease: Clinical
Presentation Number: 1154-69
- 2013 American College of Cardiology Foundation