Insulin resistance and dysglycemia are associated with left ventricular remodeling after myocardial infarction in non-diabetic patients
Blood Glucose
China
Time Factors
Ventricular Function, Left
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Risk Factors
Glucose Intolerance
Prevalence
Diseases of the circulatory (Cardiovascular) system
Humans
Original Investigation
Retrospective Studies
Left ventricular dilation
Ventricular Remodeling
Dysglycemia
Insulin resistance
Remodeling
3. Good health
Myocardial infarction
Treatment Outcome
RC666-701
ST Elevation Myocardial Infarction
Insulin Resistance
Biomarkers
DOI:
10.1186/s12933-019-0904-3
Publication Date:
2019-08-07T12:02:53Z
AUTHORS (9)
ABSTRACT
Abstract
Background
Adverse cardiac remodeling after ST-segment elevation myocardial infarction (STEMI) is a major cause for poor cardiovascular outcomes such as heart failure. The predisposing factors and underlying mechanisms remain not fully understood. This study investigates the association of insulin resistance and dysglycemia with left ventricular (LV) remodeling after STEMI in non-diabetic patients.
Methods
A total of 485 non-diabetic subjects with STEMI who underwent primary percutaneous coronary intervention were consecutively enrolled and followed up for 12 months. Relation of homeostasis model assessment-estimated insulin resistance (HOMA-IR) and glucose levels to changes in echocardiography parameters was studied.
Results
Left ventricular dilation was detected in 49.1% of subjects at 12-month follow-up after STEMI, and was more severe in subjects with impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and high HOMA-IR levels. HOMA-IR remained correlated to changes in LV dimensions after adjusting for confounding risk factors. Multivariate regression analysis demonstrated that higher HOMA-IR was independently associated with greater LV dilation after STEMI. A significant interaction term was present between HOMA-IR and IGT in the model (P = 0.001).
Conclusions
Our study reveals that insulin resistance and dysglycemia are prevalent in non-diabetic patients with STEMI and are predictors of the post-infarction LV dilation.
Trial registration Trials number, NCT02089360; registered on March 17, 2014
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