alexa Insulin Resistance and Short-Term Mortality in Patients with Acute Myocardial Infarction | OMICS International
ISSN: 2155-9880

Journal of Clinical & Experimental Cardiology
Open Access

Like us on:
OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Research Article

Insulin Resistance and Short-Term Mortality in Patients with Acute Myocardial Infarction

Rafael Sanjuan1*, Maria L Blasco1, Arturo Carratala3, Alfonso Mesejo1, Julio Nunyez2, Vicente Bodi2 and Juan Sanchis2
1Coronary Care Unit, University Clinic Hospital of Valencia, Valencia, Spain
2Hemodynamic Unit, University Clinic Hospital of Valencia, Valencia, Spain
3Service of Clinical Chemistry, University Clinic Hospital of Valencia, Valencia, Spain
Corresponding Author : Rafael Sanjuan
Coronary Care Unit
University Clinic Hospital of Valencia
AV Blasco Ibañez 17, Valencia 46010, Spain Tel: +34963862627
Fax: +34963868830
E-mail: [email protected]
Received November 08, 2011; Accepted February 13, 2012; Published February 16, 2012
Citation: Sanjuan R, Blasco ML, Carratala A, Mesejo A, Nunyez J, et al. (2012) Insulin Resistance and Short-Term Mortality in Patients with Acute Myocardial Infarction. J Clinic Experiment Cardiol 3:179. doi:10.4172/2155-9880.1000179
Copyright: © 2012 Sanjuan R, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Related article at
DownloadPubmed DownloadScholar Google

Abstract

Background: Homeostasis Model Assessment (HOMA) is a widely used index to study the role of insulin resistance (IR).Our objective has been to clarify if IR would predict short-term mortality in patients with acute myocardial infarction (AMI).

Methods: Observational prospective study in 518 consecutive patients with a clinical diagnosis of AMI with or without diabetes mellitus. We evaluated glucose and insulin levels at baseline in order to estimate IR and mortality. Association between IR and mortality was assessed by means of the Cox regression analysis, and discriminative accuracy of the multivariate model with the Harrell’s C statistic.

Results: In-hospital mortality was 6% (32/518 of patients). Using ROC curve, in non-diabetic patients, IR index >2.2 was the best cut-off for predicting in-hospital mortality with a sensitivity of 71% and specificity of 80% (AUC=0,710) (p=0,008). An IR>2.2 was present in 27% (140 patients) and this group had higher rates of NYHA>2, Body Mass Index ≥30, hypertension and diabetes mellitus. Harrell’s C statistic of 0.967 was obtained when an IR>2.2 was used in the model to predict mortality. Furthermore, mortality rose as IR values increased, from 3% IR<2 to 18% when IR>3.5. In multivariate adjusted hazard ratio analysis IR>2.2 was an independent factor for in-hospital mortality (HR=3.4; 1.2-9) (p=0.017) in addition to age >70 years (HR=3.2; 1.04-10) (p=0.04) and Killip class >1 (HR=4; 1.4-14) (p=0.012).

Conclusions:Beyond traditional cardiovascular risk factors, insulin resistance as assessed by HOMA index, seems to strongly influence prognosis and could be included in the routine clinical work up of patients with acute myocardial infarction.

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

 
© 2008- 2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version