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Abstract
Background. Insulin resistance (IR) is frequently observed in patients with coronary artery disease (CAD).
Aim. To examine the association between IR and severity and extent of CAD.
Methods. Quantitative coronary angiography (QCA) was used to assess coronary atherosclerosis in 107 patients with clinically suspected CAD. QCA‐derived indexes reflecting CAD severity, extent, and overall atheroma burden were calculated for the entire coronary tree, and separately for different coronary segments. IR was quantified using the homeostasis model assessment insulin resistance index (HOMA IR). Nondiabetic subjects (n = 83) were divided into group 1 (n = 41) with HOMA IR <1.8 (the median value), and group 2 (n = 42) with HOMA IR ⩾1.8. Group 3 comprised diabetic subjects (n = 24).
Results. Global age‐ and gender‐adjusted indexes for severity (P = 0.007), extent (P = 0.038), and atheroma burden (P = 0.035) of CAD were higher in group 2 than in group 1. Similarly, the global severity (P = 0.027), extent (P = 0.090), and global atheroma burden (P = 0.024) indexes were higher in group 3 compared with group 1. IR was correlated with quantitative angiographic indexes for distal segments only, but not for proximal or mid segments of coronary vessels.
Conclusions. Patients with more severe degree of IR have a more severe, extensive, and distal type of CAD than patients with lower degree of IR.
| Abbreviations | ||
| BMI | = | body mass index |
| CAD | = | coronary artery disease |
| DM | = | diabetes mellitus |
| HDL | = | high‐density lipoprotein |
| HOMA | = | IR, the homeostasis model assessment insulin resistance index |
| IR | = | insulin resistance |
| LDL | = | low‐density lipoprotein |
| OGTT | = | oral glucose tolerance test |
| QCA | = | quantitative coronary angiography |
| Abbreviations | ||
| BMI | = | body mass index |
| CAD | = | coronary artery disease |
| DM | = | diabetes mellitus |
| HDL | = | high‐density lipoprotein |
| HOMA | = | IR, the homeostasis model assessment insulin resistance index |
| IR | = | insulin resistance |
| LDL | = | low‐density lipoprotein |
| OGTT | = | oral glucose tolerance test |
| QCA | = | quantitative coronary angiography |
Acknowledgements
This work was supported by grants from Helsinki University Central Hospital Research Foundation, the Finnish Foundation for Cardiovascular Research, the Aarne Koskelo Foundation, and the Wilhelm and Else Stockmann Foundation.
The authors thank Tina Svahn, Hannele Hildén, and Helinä Perttunen‐Nio for their excellent technical assistance.