Background
Methods
Laboratory studies and the assessment of insulin resistance
Coronary angiography and Gensini score
Definitions concerning conventional risk factors of CHD
Statistical analysis
Results
Baseline demographics and lab results in the progression group versus non-progression group
Variables | Progression Group (n = 198) | Non-progression Group (n = 168) | p value |
---|---|---|---|
Age | 65.83 ± 11.46 | 64.74 ± 10.19 | 0.375 |
Sex(Man/Women) | 158/40 | 139/29 | 0.474 |
BMI (kg/m2) | 25.47 ± 3.18 | 24.80 ± 3.63 | 0.421 |
Hypertension (%) | 153 (77.3) | 121 (72.5) | 0.289 |
Diabetes (%) | 85 (42.9) | 51 (30.4) | 0.013 |
NGR (%) | 67 (33.8) | 86 (51.2) | 0.001 |
IFG (%) | 13 (6.6) | 7 (4.2) | 0.362 |
IGT (%) | 20 (10.1) | 18 (10.8) | 0.865 |
IFG + IGT (%) | 13 (6.6) | 6 (3.6) | 0.241 |
Initial admission n (%) | |||
ECG abnormalities | 24 (12.1) | 12 (7.1) | 0.111 |
Stable Angina | 29 (14.6) | 33 (19.6) | 0.204 |
Unstable Angina | 86 (43.4) | 70 (41.7) | 0.733 |
Non-ST elevated AMI | 10(5.1) | 9(5.4) | 0.895 |
ST elevated AMI | 49 (24.7) | 44 (26.2) | 0.752 |
Medication (%) | |||
Statin | 196 (99.5) | 165 (98.8) | 0.468 |
CCB | 67(29.6) | 55(32.9) | 0.806 |
ACEI/ARB | 104 (53.6) | 76 (46.1) | 0.154 |
β-blocker | 164 (82.8) | 128(76.6) | 0.141 |
Oral glucose lowering dug | 70(35.9) | 35(21.2) | 0.002 |
Application of insulin | 9(4.5) | 11(6.5) | 0.491 |
Variable Initial/ follow-up visit | Progression Group (n = 198) | Non-progression Group (n = 168) | p value |
---|---|---|---|
Fasting glucose (mmol/L) | 6.15 ± 1.81 | 5.49 ± 1.25 | <0.001 |
7.84 ± 1.80 | 5.30 ± 1.22 | 0.005 | |
OGTT (mmol/L) | 10.09 ± 4.17 | 8.65 ± 3.41 | <0.001 |
9.68 ± 3.79 | 8.47 ± 3.38 | 0.002 | |
Fasting insulin (mU/L) | 13.50 ± 26.58 | 12.57 ± 27.04 | 0.010 |
14.43 ± 19.01 | 17.10 ± 60.81 | 0.002 | |
Postprandial insulin (mU/L) | 78.31 ± 117.74 | 62.43 ± 65.86 | 0.388 |
80.27 ± 71.31 | 88.35 ± 107.35 | 0.868 | |
Bennett index | 1.79 ± 0.65 | 0.41 ± 0.56 | <0.001 |
0.95 ± 0.84 | 0.67 ± 0.95 | <0.001 | |
HbA1c (%) | 6.73 ± 1.40 | 6.24 ± 0.98 | 0.001 |
6.79 ± 1.53 | 6.07 ± 0.78 | <0.001 | |
hsCRP (mg/L) | 9.28 ± 13.56 | 13.34 ± 22.51 | 0.600 |
6.55 ± 12.01 | 2.68 ± 4.14 | 0.048 | |
BUN (mmol/L) | 5.44 ± 1.59 | 5.45 ± 1.50 | 0.941 |
6.06 ± 1.90 | 5.70 ± 1.48 | 0.623 | |
Creatinine (umol/L) | 84.47 ± 18.34 | 89.90 ± 36.51 | 0.671 |
93.11 ± 23.46 | 87.28 ± 18.87 | 0.585 | |
Urine acid (umol/L) | 339.83 ± 76.41 | 339.30 ± 85.77 | 0.878 |
358.38 ± 81.25 | 362.80 ± 79.00 | 0.966 | |
Urine Ma/Cr | 12.12 ± 49.70 | 3.65 ± 18.74 | 0.011 |
16.00 ± 69.94 | 2.09 ± 3.14 | 0.366 | |
GFR (ml/min) | 80.16 ± 25.46 | 76.62 ± 28.98 | 0.345 |
73.52 ± 25.48 | 71.55 ± 23.33 | 0.049 | |
Serum triglyceride (mmol/L) | 2.13 ± 1.72 | 1.86 ± 2.01 | 0.072 |
1.76 ± 1.34 | 1.65 ± 1.50 | 0.207 | |
Serum cholesterol (mmol/L) | 4.58 ± 1.22 | 4.18 ± 1.09 | 0.103 |
2.08 ± 0.76 | 2.05 ± 0.78 | 0.412 | |
HDL (mmol/L) | 1.05 ± 0.23 | 1.05 ± 0.26 | 0.706 |
1.06 ± 0.26 | 1.14 ± 0.26 | 0.246 | |
LDL (mmol/L) | 2.81 ± 0.96 | 2.45 ± 0.84 | 0.118 |
2.08 ± 0.76 | 2.05 ± 0.78 | 0.412 | |
Lpa (mmol/L) | 0.21 ± 0.21 | 0.20 ± 0.18 | 0.941 |
0.21 ± 0.17 | 0.30 ± 0.49 | 0.317 | |
ApoA (mmol/L) | 1.13 ± 0.22 | 1.12 ± 0.20 | 0.764 |
1.11 ± 0.22 | 1.12 ± 0.29 | 0.738 | |
ApoB (mmol/L) | 0.93 ± 0.28 | 0.87 ± 0.26 | 0.342 |
0.80 ± 0.25 | 0.77 ± 0.23 | 0.225 | |
Ejection Fraction | 62.50 ± 9.06 | 64.01 ± 6.86 | 0.331 |
62.62 ± 8.38 | 62.62 ± 8.20 | 0.153 |
Variables | Progression Group (N = 198) | Non-progression Group (N = 168) | p value |
---|---|---|---|
Baseline Clinical presentation | |||
n (%) | |||
STEMI | 49 (24.7) | 44 (26.2) | 0.752 |
NSTEMI | 10 (5.1) | 9 (5.4) | 0.895 |
SAP | 29 (14.6) | 33 (19.6) | 0.204 |
UAP | 86 (43.4) | 70 (41.7) | 0.733 |
ECG abnormalities | 24 (12.1) | 12 (7.1) | 0.111 |
Number of vessel affected n | 0.332 | ||
(%) | |||
Without lesions | 2 (1.0) | 4 (2.4) | |
Single vessel | 50 (25.3) | 56 (33.3) | |
Double vessel | 69 (34.8) | 55 (32.7) | |
Three vessel | 74 (37.4) | 51 (30.4) | |
Multiple vessel | 3 (1.5) | 2 (1.2) | |
Characteristics of lesion n | |||
(%) | |||
Diffuse lesion | 51 (25.8) | 53 (31.5) | 0.221 |
Calcification | 14 (7.1) | 21 (12.5) | 0.078 |
Bifurcation | 13 (6.6) | 16 (9.5) | 0.296 |
Opening lesion | 14 (7.1) | 16 (9.5) | 0.394 |
Occlusive lesion | 37 (18.7) | 33 (19.6) | 0.817 |
Difference value of Variables | Progression group (n = 198) | Non-progression group (n = 168) | p value |
---|---|---|---|
Glucose | 0.21 ± 2.20 | −0.19 ± 1.27 | 0.136 |
OGTT | −0.42 ± 3.92 | −0.67 ± 2.87 | 0.025 |
Insulin | 6.00 ± 23.46 | 2.42 ± 11.90 | 0.347 |
Insulin2h | 20.75 ± 58.80 | 14.65 ± 49.81 | 0.200 |
SBP | −6.80 ± 21.76 | 2.68 ± 19.54 | 0.327 |
DBP | −5.65 ± 11.95 | −1.58 ± 13.80 | 0.637 |
PP | −1.15 ± 18.76 | 4.26 ± 15.99 | 0.925 |
MAP | −6.03 ± 13.22 | −0.16 ± 14.05 | 0.517 |
HbA1c | 0.17 ± 1.28 | 0.02 ± 0.97 | 0.339 |
hsCRP | −4.61 ± 18.68 | −11.19 ± 21.90 | 0.659 |
BUN | 0.22 ± 1.39 | 0.48 ± 1.85 | 0.525 |
Creatinine | 3.33 ± 16.63 | 4.28 ± 10.42 | 0.948 |
UA | 20.25 ± 49.91 | 41.06 ± 70.41 | 0.311 |
GFR | −3.17 ± 12.38 | −5.90 ± 14.05 | 0.520 |
Urine Malb/Cr | 0.89 ± 66.12 | 0.20 ± 1.83 | 0.491 |
TG | −0.29 ± 0.91 | −0.36 ± 1.58 | 0.279 |
TC | −0.90 ± 0.91 | −0.57 ± 1.09 | 0.285 |
LDL | 0.16 ± 0.43 | 0.16 ± 0.30 | 0.321 |
HDL | 0.02 ± 0.22 | 0.06 ± 0.21 | 0.124 |
Lpa | −0.01 ± 0.09 | 0.14 ± 0.59 | 0.114 |
ApoA | 0.02 ± 0.23 | 0.11 ± 0.25 | 0.919 |
ApoB | −0.09 ± 0.26 | −0.08 ± 0.23 | 0.609 |
LVEF | −1.05 ± 5.65 | −0.43 ± 5.83 | 0.561 |
Follow-up lab results, angiogram and Gensini score between the Higher Insulin Resistant group and Lower Insulin Resistant group
Variables At the follow-up visit | Higher IR group (n = 71) | Lower IR group (n = 213) | p value |
---|---|---|---|
BMI | 27.69 ± 4.17 | 24.13 ± 2.65 | <0.001 |
Prevalence of hypertension | 60 (84.5%) | 148 (70.0%) | 0.013 |
Prevalence of diabetes | 44 (62.0%) | 72 (33.8%) | <0.001 |
Fasting glucose | 7.84 ± 1.80 | 5.30 ± 1.22 | 0.005 |
OGTT | 10.51 ± 3.98 | 8.73 ± 3.43 | 0.002 |
Fasting insulin | 39.36 ± 96.93 | 10.36 ± 9.56 | 0.002 |
Postrandial insulin | 135.52 ± 148.57 | 68.41 ± 60.23 | <0.001 |
Bonnet index | 0.95 ± 0.84 | 0.67 ± 0.95 | <0.001 |
HbA1c | 6.79 ± 1.53 | 6.07 ± 0.78 | <0.001 |
GFR | 79.46 ± 28.19 | 70.38 ± 21.72 | 0.016 |
Triglycerides | 2.09 ± 1.75 | 1.52 ± 1.01 | 0.002 |
hsCRP | 8.54 ± 13.78 | 3.87 ± 7.45 | 0.005 |
Higher IR group (n = 71) | Lower IR group (n = 213) | p value | |
---|---|---|---|
Initial gensini score | 9.09 ± 14.33 | 9.44 ± 12.88 | 0.813 |
Follow-up gensini score | 17.21 ± 18.46 | 14.09 ± 14.18 | 0.358 |
Difference value during | 8.13 ± 11.83 | 4.65 ± 7.58 | 0.019 |
1-year peroid | |||
Follow-up angiogram (%) | |||
Progression of plaques | 46(65.7) | 101(47.6) | 0.009 |
Revascularization | 28 (40.6) | 77(36.7) | 0.561 |
New lesion in different | 33 (47.1) | 58 (27.4) | 0.002 |
vessel | |||
Exacerbation of original | 16 (22.9) | 19 (9.0) | 0.002 |
lesion | |||
In-stent restenosis | 13(18.3) | 31(14.6) | 0.449 |
Multivariable regression analysis of related risk factors towards atherosclerotic progression
Variable | OR value | 95%CI | p value |
---|---|---|---|
HOMA-IRI > 3.458 | 4.969 | 0.630-6.475 | 0.011 |
HbA1c | 1.721 | 0.256-4.515 | 0.034 |
Subgroups | Variable | OR value | 95%CI | p value |
---|---|---|---|---|
Non-DM | HOMA-IRI > 3.458 | 7.528 | 0.973-4.300 | 0.034 |
DM | HOMA-IRI > 3.458 | 7.590 | 0.987-4.220 | 0.040 |