PMID- 19367169
OWN - NLM
STAT- MEDLINE
DCOM- 20091204
LR  - 20101118
IS  - 1365-2346 (Electronic)
IS  - 0265-0215 (Linking)
VI  - 26
IP  - 10
DP  - 2009 Oct
TI  - Prognostic role of insulin resistance as assessed by homeostatic model assessment 
      index in the acute phase of myocardial infarction in nondiabetic patients 
      submitted to percutaneous coronary intervention.
PG  - 856-62
LID - 10.1097/EJA.0b013e32832a235c [doi]
AB  - BACKGROUND AND OBJECTIVES: Little information is available on the relation 
      between insulin resistance and acute myocardial infarction. METHODS: In 253 
      consecutive nondiabetic patients with ST elevation myocardial infarction (STEMI) 
      submitted to percutaneous coronary intervention, we assessed the prevalence of 
      insulin resistance by homeostatic model assessment (HOMA) index and its 
      prognostic role in early and late mortality. RESULTS: Insulin resistance was 
      detectable in 52.9% of patients. Anterior STEMI was more frequent in 
      insulin-resistant patients (P = 0.040), who showed higher values of probrain 
      natriuretic peptide (P = 0.010), creatinine (P < 0.001), creatinine phosphokinase 
      and creatinine phosphokinase-MB (MB, isoenzyme present in the myocardium; P = 
      0.016 and P = 0.003, respectively). At backward stepwise logistic regression 
      analysis, the following variables were independent predictors for intra-intensive 
      cardiac care unit mortality: HOMA index [hazard ratio 1.40; 95% confidence 
      interval (CI) 1.02-1.95; P = 0.049]; C-peptide (hazard ratio 3.14; 95% CI 
      1.40-24.80; P = 0.001) and lactic acid (hazard ratio 2.50; 95% CI 1.41-4.44; P = 
      0.002). At long-term follow-up (Cox regression analysis), neither fasting 
      glycaemia nor HOMA index resulted in predictors for mortality. CONCLUSION: In 
      nondiabetic STEMI patients submitted to percutaneous coronary intervention, 
      insulin resistance, as assessed by HOMA index, is quite common and helps in the 
      early prognostic stratification, as it represents an independent predictor of 
      in-hospital mortality.
FAU - Lazzeri, Chiara
AU  - Lazzeri C
AD  - Intensive Cardiac Care Unit, Heart and Vessel Department, Azienda 
      Ospedaliero-Universitaria Careggi, Florence, Italy. lazzeric@libero.it
FAU - Sori, Andrea
AU  - Sori A
FAU - Chiostri, Marco
AU  - Chiostri M
FAU - Gensini, Gian Franco
AU  - Gensini GF
FAU - Valente, Serafina
AU  - Valente S
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur J Anaesthesiol
JT  - European journal of anaesthesiology
JID - 8411711
SB  - IM
MH  - Aged
MH  - Angioplasty, Balloon, Coronary/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - *Homeostasis
MH  - Hospital Mortality
MH  - Humans
MH  - *Insulin Resistance
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnosis/mortality
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Prospective Studies
EDAT- 2009/04/16 09:00
MHDA- 2009/12/16 06:00
CRDT- 2009/04/16 09:00
PHST- 2009/04/16 09:00 [entrez]
PHST- 2009/04/16 09:00 [pubmed]
PHST- 2009/12/16 06:00 [medline]
AID - 10.1097/EJA.0b013e32832a235c [doi]
PST - ppublish
SO  - Eur J Anaesthesiol. 2009 Oct;26(10):856-62. doi: 10.1097/EJA.0b013e32832a235c.