Hyperinsulinaemia is associated with increased long-term mortality following acute myocardial infarction in non-diabetic patients?
| Autor: | Jens-Jørgen Kjærgaard, Søren Højberg, Carlsen Je, Bruno Bengtsson, Claus Olesen, Michael Ottesen, Christian Torp-Petersen, Lars Køber, Charlotte Kragelund, Ole Snorgaard |
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| Rok vydání: | 2004 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Heart disease medicine.medical_treatment Myocardial Ischemia Insulin resistance Risk Factors Hyperinsulinism Internal medicine Diabetes mellitus medicine Hyperinsulinemia Albuminuria Humans Insulin Myocardial infarction Risk factor Aged Aged 80 and over Glycated Hemoglobin business.industry Middle Aged medicine.disease Endocrinology Heart failure Cardiology Regression Analysis Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal. 25:1891-1897 |
| ISSN: | 0195-668X |
| Popis: | Aims To study the impact of disturbances in glucose metabolism on total mortality in non-diabetic patients with acute myocardial infarction. Methods and results Four hundred and ninety four patients with a verified myocardial infarction and no history of diabetes were studied. The study population comprised a subgroup of patients screened for participation in the Trandolapril Cardiac Evaluation (TRACE) study. At baseline, fasting insulin, fasting glucose, glycosylated haemoglobin (HbA1c), and urinary albumin excretion were measured. Survival status was determined after 6–8 years. Patients with hyperinsulinaemia were more obese and more frequently suffered from hypertension, previous myocardial infarction and congestive heart failure. In a univariate regression analysis, values in the upper quartile of insulin, glucose, HbA1c, and urinary albumin were associated with an excess mortality risk (RR=1.8 (1.2–2.7), p =0.002; RR=1.6 (1.2–2.1), p =0.001; RR= 1.9 (1.3–2.9), p =0.001; RR=1.6 (1.2–2.1), p =0.02 respectively). However, only a high insulin level remained significant in a multivariable analysis (RR=1.54 (1.03–2.31), p =0.04) including baseline variables, left ventricular systolic function and in-hospital complications. Conclusions High fasting plasma insulin is an independent risk factor of all-cause mortality in non-diabetic patients with acute myocardial infarction. This justifies future intervention studies aiming at reducing insulin resistance and using fasting insulin as the target variable. |
| Databáze: | OpenAIRE |
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