Abstract
Background: Type 2 diabetes mellitus is often associated with severe Coronary artery disease (CAD). Since patients with higher risk of severe disease are likely to get better benefit from aggressive management, it is essential to identify factors which are associated with severe macrovascular disease. We looked at the possibility of hyperinsulinemia being a marker for severe and complex coronary artery disease in type 2 diabetes mellitus, to select patients who would benefit from aggressive treatment. Methods: A cross sectional study of 290 type 2 diabetic patients, who underwent coronary angiogram for the evaluation of clinically suspected CAD at a tertiary care hospital were recruited. Biochemical and anthropometric parameters were analysed. Insulin resistance was measured by homeostasis model assessment method. Angiographically measured syntax score of more than 22 is considered to be severe and complex CAD. Receiver operating curve characteristic was performed to find out the optimal cut-off value for insulin resistance and fasting insulin. Predictors of syntax score greater than 22 were identified by multiple logistic regression analysis. Results: An insulin level > 20 μIU/ml (OR: 6.86, 95% CI: 2.25-20.88) emerged as an independent predictor of severe and complex CAD. The optimal cut-off of insulin for predicting severe CAD was 20 with sensitivity and specificity of 80% (95% CI: 0.68 - 0.88) and 79% (95% CI: 0.73 - 0.83) respectively. Conclusion: Hyperinsulinemia could serve as a marker to identify severe and complex CAD in type 2 diabetes at an earlier stage of diabetes.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 19-23 |
| Number of pages | 5 |
| Journal | Journal of Cardiovascular Disease Research |
| Volume | 8 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2017 |
| Externally published | Yes |
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Keywords
- Coronary artery disease
- Hyperinsulinemia
- Insulin resistance
- Syntax score
- Type 2 diabetes mellitus
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Risk factors for complex and severe Coronary artery disease in type 2 diabetes mellitus. / Prathivadibhayankaram, Mukund; Bhat, Narayan; Kamath, Padmanabh; Pai, Narasimha; Manjrekar, Poornima; Narasimhan, Bharat; Mahabala, Chakrapani.
In: Journal of Cardiovascular Disease Research, Vol. 8, No. 1, 01.01.2017, p. 19-23.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Risk factors for complex and severe Coronary artery disease in type 2 diabetes mellitus
AU - Prathivadibhayankaram, Mukund
AU - Bhat, Narayan
AU - Kamath, Padmanabh
AU - Pai, Narasimha
AU - Manjrekar, Poornima
AU - Narasimhan, Bharat
AU - Mahabala, Chakrapani
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background: Type 2 diabetes mellitus is often associated with severe Coronary artery disease (CAD). Since patients with higher risk of severe disease are likely to get better benefit from aggressive management, it is essential to identify factors which are associated with severe macrovascular disease. We looked at the possibility of hyperinsulinemia being a marker for severe and complex coronary artery disease in type 2 diabetes mellitus, to select patients who would benefit from aggressive treatment. Methods: A cross sectional study of 290 type 2 diabetic patients, who underwent coronary angiogram for the evaluation of clinically suspected CAD at a tertiary care hospital were recruited. Biochemical and anthropometric parameters were analysed. Insulin resistance was measured by homeostasis model assessment method. Angiographically measured syntax score of more than 22 is considered to be severe and complex CAD. Receiver operating curve characteristic was performed to find out the optimal cut-off value for insulin resistance and fasting insulin. Predictors of syntax score greater than 22 were identified by multiple logistic regression analysis. Results: An insulin level > 20 μIU/ml (OR: 6.86, 95% CI: 2.25-20.88) emerged as an independent predictor of severe and complex CAD. The optimal cut-off of insulin for predicting severe CAD was 20 with sensitivity and specificity of 80% (95% CI: 0.68 - 0.88) and 79% (95% CI: 0.73 - 0.83) respectively. Conclusion: Hyperinsulinemia could serve as a marker to identify severe and complex CAD in type 2 diabetes at an earlier stage of diabetes.
AB - Background: Type 2 diabetes mellitus is often associated with severe Coronary artery disease (CAD). Since patients with higher risk of severe disease are likely to get better benefit from aggressive management, it is essential to identify factors which are associated with severe macrovascular disease. We looked at the possibility of hyperinsulinemia being a marker for severe and complex coronary artery disease in type 2 diabetes mellitus, to select patients who would benefit from aggressive treatment. Methods: A cross sectional study of 290 type 2 diabetic patients, who underwent coronary angiogram for the evaluation of clinically suspected CAD at a tertiary care hospital were recruited. Biochemical and anthropometric parameters were analysed. Insulin resistance was measured by homeostasis model assessment method. Angiographically measured syntax score of more than 22 is considered to be severe and complex CAD. Receiver operating curve characteristic was performed to find out the optimal cut-off value for insulin resistance and fasting insulin. Predictors of syntax score greater than 22 were identified by multiple logistic regression analysis. Results: An insulin level > 20 μIU/ml (OR: 6.86, 95% CI: 2.25-20.88) emerged as an independent predictor of severe and complex CAD. The optimal cut-off of insulin for predicting severe CAD was 20 with sensitivity and specificity of 80% (95% CI: 0.68 - 0.88) and 79% (95% CI: 0.73 - 0.83) respectively. Conclusion: Hyperinsulinemia could serve as a marker to identify severe and complex CAD in type 2 diabetes at an earlier stage of diabetes.
KW - Coronary artery disease
KW - Hyperinsulinemia
KW - Insulin resistance
KW - Syntax score
KW - Type 2 diabetes mellitus
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UR - http://www.scopus.com/inward/citedby.url?scp=85016960896&partnerID=8YFLogxK
U2 - 10.5530/jcdr.2017.1.4
DO - 10.5530/jcdr.2017.1.4
M3 - Article
VL - 8
SP - 19
EP - 23
JO - Journal of Cardiovascular Disease Research
JF - Journal of Cardiovascular Disease Research
SN - 0975-3583
IS - 1
ER -