Author + information
- Seung Hwan Han,
- Pyung Chun Oh,
- Min Soo Kim,
- Yae Min Park,
- Kwang Kon Koh and
- Eak Kyun Shin
Detailed relationships between insulin resistance (IR) and vulnerable plaque are not clear, therefore, we sought the role of IR and metabolic risk factors on culprit coronary plaque.
Plaque components at a region of interest (ROI, 10mm) were analyzed by virtual histology intravascular ultrasound. IR was defined as quantitative insulin sensitivity check index (QUICKI) ≤ 0.33. Seven metabolic risk factors (5 risk factors for metabolic syndrome defined by ATP III, history of smoking, hsCRP) for IR were determined.
The data for 150 (males 104) patients were analyzed. Patients with IR (n = 69) had greater necrotic core (NC) at ROI (21.2 ± 15.8 mm3 vs 15.7 ± 11.9 mm3, p = 0.02) than in patients without IR (n = 81). The NC at ROI was correlated with QUICKI (r = -0.16, p = 0.05), HbA1C (r = 0.24, p < 0.01), body mass index (r = 0.17, p = 0.04), presence of diabetes mellitus (r = 0.29, p < 0.001), hsCRP (r = 0.17, p = 0.04) and the numbers of risk factors for IR (r = 0.41, p < 0.001). The multivariate analysis revealed that the numbers of risk factors for IR was an independent factor for NC at ROI (beta coefficient = 0.44, p = 0.003), but QUICKI was not (beta coefficient = -0.01, p = 0.94).
Instead of a single measurement of IR index or each metabolic risk factor, clustering of risk factors for IR plays an important role on plaque vulnerability.