ArticleCardiovascular diabetology2016
Insulin resistance, endothelial function, angiogenic factors and clinical outcome in non-diabetic patients with chest pain without myocardial perfusion defects.
Article in Cardiovascular diabetology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 39 citations in OpenAlex.
- Effect of Metformin on Microvascular Endothelial Function in Polycystic Ovary Syndrome.Mayo Clinic proceedings · 2019Trial
- Triglyceride-glucose index at ICU admission predicts hospital mortality in patients with acute coronary syndrome concomitant sepsis: a Bayesian network analysis of retrospective multicenter cohort study.Frontiers in nutrition · 2026Article
- Low estimated glucose disposal rate predicts high residual syntax score in non-diabetic ST-elevation myocardial infarction patients.Diabetology & metabolic syndrome · 2025Article
- Association between estimated glucose disposal rate and testosterone level in US adult men: insights from NHANES 2013-2016.Sexual medicine · 2025Article
- A cross-sectional study exploring relationships between triglyceride glucose index, atherogenic index of plasma, and chronic pain: NHANES 1999-2004.Lipids in health and disease · 2025Article
- Association of estimated glucose disposal rate with metabolic syndrome prevalence and mortality risks: a population-based study.Cardiovascular diabetology · 2025Article
- Association between insulin resistance and coronary microcirculatory function and adverse cardiovascular events after PCI in non-diabetic STEMI patients.Frontiers in cardiovascular medicine · 2025Article
- Associations of triglyceride-glucose (TyG) index with chest pain incidence and mortality among the U.S. population.Cardiovascular diabetology · 2024Article
- Primordial Drivers of Diabetes Heart Disease: Comprehensive Insights into Insulin Resistance.Diabetes & metabolism journal · 2024Review
- Assessing interstitial fluid dynamics in type 2 diabetes mellitus and prediabetes cases through diffusion tensor imaging analysis along the perivascular space.Frontiers in aging neuroscience · 2024Article
- Cardioprotective effect of extracellular vesicles derived from ticagrelor-pretreated cardiomyocyte on hyperglycemic cardiomyocytes through alleviation of oxidative and endoplasmic reticulum stress.Scientific reports · 2022Article
- Insulin resistance in ischemic stroke: Mechanisms and therapeutic approaches.Frontiers in endocrinology · 2022Review
- Short-term effect of sacubitril/valsartan on endothelial dysfunction and arterial stiffness in patients with chronic heart failure.Frontiers in pharmacology · 2022Article
- Evaluation of Endothelial Dysfunction in Bipolar Affective Disorders: Serum Endocan and Urotensin-II Levels.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2019Article
- Endothelial dysfunction and platelet hyperactivity in type 2 diabetes mellitus: molecular insights and therapeutic strategies.Cardiovascular diabetology · 2018Review
- Association between insulin resistance and the development of cardiovascular disease.Cardiovascular diabetology · 2018Review
- Article
- Which factor is the most effective one in metabolic Sydrome on the outcomes after coronary artery bypass graft surgery? A cohort study of 5 Years.Journal of cardiothoracic surgery · 2018Article
- Identification of novel biomarkers to monitor β-cell function and enable early detection of type 2 diabetes risk.PloS one · 2017Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with angina-like symptoms without myocardial perfusion scintigram (MPS)-verified abnormality may still be at risk for cardiovascular events. We hypothesized that insulin resistance could play a role in this population even without diagnosed diabetes. We further explored physiological and blood biomarkers, as well as global gene expression patterns that could be closely related to impaired glucose homeostasis to deepen our mechanistic understanding.
methodsA total of 365 non-diabetic patients with suspected myocardial ischemia referred to MPS were enrolled and followed up regarding event-free survival with a median time of 5.1 years. All patients underwent endothelial function assessment by reactive hyperemic index (RHI) using EndoPAT and extensive biomarker analysis. Whole blood global gene expression pathway analysis was performed in a subset of patients.
resultsHomeostasis model assessment of insulin resistance (HOMA-IR) added independent prognostic value in patients without myocardial perfusion defects. In a multivariable analysis, HOMA-IR was inversely associated with low RHI. Furthermore, elevated HOMA-IR was associated with decreased levels of vascular endothelial growth factor D, stem cell factor and endocan as well as to increased level of interleukin-6. Global gene expression pathway analysis of whole blood cells showed that high HOMA-IR and impaired endothelial function were associated with upregulated pro-inflammatory pathways and down-regulated eukaryotic initiation factor-2 pathway.
conclusionsInsulin resistance measured by HOMA-IR is associated with endothelial dysfunction and confers independent prognostic information in non-diabetic patients with chest pain without myocardial perfusion defects. Increased systemic pro-inflammatory state and decreased levels of pro-angiogenic vascular growth factors may be important underlying molecular mechanisms.
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