Impact of Hyperinsulinemia on Long-Term Clinical Outcomes of Percutaneous Coronary Intervention in Patients without Diabetes Who Have Acute Myocardial Syndrome

Qiang Tan, Ming Chen, Jia Hao, Kun Wei Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Qinhuangdao, Hebei Province, People’s Republic of ChinaCorrespondence: Qiang TanDepartment of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, No. 258 of Wenhua Roa...

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Autores principales:	Tan Q, Chen M, Hao J, Wei K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	percutaneous coronary intervention hyperinsulinemia acute myocardial syndrome major adverse cardiac events Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/a425895e77bf4aab9e49aefd86377d28
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spelling	oai:doaj.org-article:a425895e77bf4aab9e49aefd86377d282021-12-02T14:55:28ZImpact of Hyperinsulinemia on Long-Term Clinical Outcomes of Percutaneous Coronary Intervention in Patients without Diabetes Who Have Acute Myocardial Syndrome1178-7007https://doaj.org/article/a425895e77bf4aab9e49aefd86377d282021-09-01T00:00:00Zhttps://www.dovepress.com/impact-of-hyperinsulinemia-on-long-term-clinical-outcomes-of-percutane-peer-reviewed-fulltext-article-DMSOhttps://doaj.org/toc/1178-7007Qiang Tan, Ming Chen, Jia Hao, Kun Wei Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Qinhuangdao, Hebei Province, People’s Republic of ChinaCorrespondence: Qiang TanDepartment of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, No. 258 of Wenhua Road, Qinhuangdao, Hebei Province, 066000, People’s Republic of ChinaEmail qhdtanqiang@aliyun.comBackground and Objectives: Hyperinsulinemia plays a key role in the development of cardiovascular impairment in patients with metabolic syndrome. The aim of this study was to evaluate the influence of hyperinsulinemia on long-term clinical outcomes of percutaneous coronary intervention (PCI) in patients without diabetes mellitus who have acute myocardial syndrome (ACS).Methods: Between March 2016 and January 2019, we enrolled 468 patients with ACS and without diabetes mellitus who received primary PCI. Patients were divided into a low-insulin group (n = 157), medium-insulin group (n = 154), and high-insulin group (n = 157) according to tertiles of fasting insulin level. The primary endpoint was major adverse cardiac events (MACE; all-cause death, non-fatal myocardial infarction, target vessel revascularization [TVR]) at 24 months. The secondary endpoint was angina hospitalization.Results: Patients in the high-insulin group had an unfavorable prognosis, with a higher rate of MACE (34.39%) than the low-insulin group (22.29%) and medium-insulin group (23.37%) at 24 months (P < 0.05). This difference was mainly driven by the increase in TVR. The high-insulin group also had a higher rate of angina hospitalization than the low-insulin group. Cox proportional hazards regression showed that high-insulin level (hazard ratio [HR] 1.870, 95% confidence interval [CI] 1.202– 2.909), small-vessel lesion (HR 1.713, 95% CI 1.111– 2.642), bifurcation lesion (HR 3.394, 95% CI 2.033– 5.067), SYNTAX score (HR 1.084, 95% CI 1.039– 1.130), and stent length (HR 1.017, 95% CI 1.002– 1.032) increased the incidence of MACE in patients with ACS and without diabetes who underwent PCI.Conclusion: Hyperinsulinemia might be a valid predictor of clinical outcomes in patients with ACS undergoing PCI.Keywords: percutaneous coronary intervention, hyperinsulinemia, acute myocardial syndrome, major adverse cardiac eventsTan QChen MHao JWei KDove Medical Pressarticlepercutaneous coronary interventionhyperinsulinemiaacute myocardial syndromemajor adverse cardiac eventsSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 14, Pp 3949-3957 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	percutaneous coronary intervention hyperinsulinemia acute myocardial syndrome major adverse cardiac events Specialties of internal medicine RC581-951
spellingShingle	percutaneous coronary intervention hyperinsulinemia acute myocardial syndrome major adverse cardiac events Specialties of internal medicine RC581-951 Tan Q Chen M Hao J Wei K Impact of Hyperinsulinemia on Long-Term Clinical Outcomes of Percutaneous Coronary Intervention in Patients without Diabetes Who Have Acute Myocardial Syndrome
description	Qiang Tan, Ming Chen, Jia Hao, Kun Wei Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Qinhuangdao, Hebei Province, People’s Republic of ChinaCorrespondence: Qiang TanDepartment of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, No. 258 of Wenhua Road, Qinhuangdao, Hebei Province, 066000, People’s Republic of ChinaEmail qhdtanqiang@aliyun.comBackground and Objectives: Hyperinsulinemia plays a key role in the development of cardiovascular impairment in patients with metabolic syndrome. The aim of this study was to evaluate the influence of hyperinsulinemia on long-term clinical outcomes of percutaneous coronary intervention (PCI) in patients without diabetes mellitus who have acute myocardial syndrome (ACS).Methods: Between March 2016 and January 2019, we enrolled 468 patients with ACS and without diabetes mellitus who received primary PCI. Patients were divided into a low-insulin group (n = 157), medium-insulin group (n = 154), and high-insulin group (n = 157) according to tertiles of fasting insulin level. The primary endpoint was major adverse cardiac events (MACE; all-cause death, non-fatal myocardial infarction, target vessel revascularization [TVR]) at 24 months. The secondary endpoint was angina hospitalization.Results: Patients in the high-insulin group had an unfavorable prognosis, with a higher rate of MACE (34.39%) than the low-insulin group (22.29%) and medium-insulin group (23.37%) at 24 months (P < 0.05). This difference was mainly driven by the increase in TVR. The high-insulin group also had a higher rate of angina hospitalization than the low-insulin group. Cox proportional hazards regression showed that high-insulin level (hazard ratio [HR] 1.870, 95% confidence interval [CI] 1.202– 2.909), small-vessel lesion (HR 1.713, 95% CI 1.111– 2.642), bifurcation lesion (HR 3.394, 95% CI 2.033– 5.067), SYNTAX score (HR 1.084, 95% CI 1.039– 1.130), and stent length (HR 1.017, 95% CI 1.002– 1.032) increased the incidence of MACE in patients with ACS and without diabetes who underwent PCI.Conclusion: Hyperinsulinemia might be a valid predictor of clinical outcomes in patients with ACS undergoing PCI.Keywords: percutaneous coronary intervention, hyperinsulinemia, acute myocardial syndrome, major adverse cardiac events
format	article
author	Tan Q Chen M Hao J Wei K
author_facet	Tan Q Chen M Hao J Wei K
author_sort	Tan Q
title	Impact of Hyperinsulinemia on Long-Term Clinical Outcomes of Percutaneous Coronary Intervention in Patients without Diabetes Who Have Acute Myocardial Syndrome
title_short	Impact of Hyperinsulinemia on Long-Term Clinical Outcomes of Percutaneous Coronary Intervention in Patients without Diabetes Who Have Acute Myocardial Syndrome
title_full	Impact of Hyperinsulinemia on Long-Term Clinical Outcomes of Percutaneous Coronary Intervention in Patients without Diabetes Who Have Acute Myocardial Syndrome
title_fullStr	Impact of Hyperinsulinemia on Long-Term Clinical Outcomes of Percutaneous Coronary Intervention in Patients without Diabetes Who Have Acute Myocardial Syndrome
title_full_unstemmed	Impact of Hyperinsulinemia on Long-Term Clinical Outcomes of Percutaneous Coronary Intervention in Patients without Diabetes Who Have Acute Myocardial Syndrome
title_sort	impact of hyperinsulinemia on long-term clinical outcomes of percutaneous coronary intervention in patients without diabetes who have acute myocardial syndrome
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/a425895e77bf4aab9e49aefd86377d28
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Impact of Hyperinsulinemia on Long-Term Clinical Outcomes of Percutaneous Coronary Intervention in Patients without Diabetes Who Have Acute Myocardial Syndrome

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