ArticleDiabetes, metabolic syndrome and obesity : targets and therapy2021
Impact of Hyperinsulinemia on Long-Term Clinical Outcomes of Percutaneous Coronary Intervention in Patients without Diabetes Who Have Acute Myocardial Syndrome.
Article in Diabetes, metabolic syndrome and obesity : targets and therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 4 citations in OpenAlex.
- Relationship Between Hyperinsulinemia and Coronary Microvascular Disease.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
- Hyperinsulinemia Impaired Coronary Collateral Circulation in Patients with Chronic Total Coronary Occlusion.Diabetes, metabolic syndrome and obesity : targets and therapy · 2023Article
- Clinical outcomes of drug-coated balloon for treatment of de novo coronary artery disease with and without diabetes.Saudi medical journal · 2022Article
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Authors and funding
4 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesHyperinsulinemia 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).
methodsBetween 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.
resultsPatients 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.
conclusionHyperinsulinemia might be a valid predictor of clinical outcomes in patients with ACS undergoing PCI.
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