Components of the insulin resistance syndrome are associated with progression of atherosclerosis in non-grafted arteries 5 years after coronary artery bypass surgery.
OBJECTIVE
Risk factors for progression of atherosclerosis in non-grafted coronary arteries were examined in a prospective 5-year follow-up study of 228 consecutive coronary artery bypass surgery patients, with the main emphasis on insulin resistance syndrome.


RESULTS
Serum lipids and lipoproteins were measured pre-operatively and 1, 2, 3 and 5 years after surgery; and a baseline oral glucose tolerance test with plasma insulin determinations was performed pre-operatively. Progression of atherosclerosis was assessed by means of computer-based quantitative coronary angiography. Compared to subjects without progression, the patients with progression of atherosclerotic lesions had a higher body mass index both at baseline (P = 0.022) and at 5 years (P = 0.007), were more often treated for hypertension at baseline (P = 0.008) and at 5 years (P = 0.012), used diuretics more often during the follow-up period (P = 0.002), had a larger blood glucose area under the curve (P = 0.015) and a lower insulin sensitivity index (P = 0.006) in the baseline oral glucose tolerance test, had a higher serum total cholesterol concentration at baseline (P = 0.044), and a higher serum triglyceride concentration (P = 0.005) during the whole follow-up period. Clustering of the components of insulin resistance syndrome at baseline was more frequently found in patients with progression of atherosclerotic lesions than in patients without progression (P = 0.025). For example, for patients with < or = 1 component, the risk of progression was 17%, while for patients with > or = 5 components the risk was 67%. As compared to the other patients, those with new atherosclerotic lesions had a lower insulin sensitivity index at baseline (P = 0.033), and a lower serum high density lipoprotein cholesterol concentration during the follow-up period (P = 0.033).


CONCLUSIONS
In addition to high serum cholesterol, the components of the insulin resistance syndrome are associated with progression of atherosclerosis in non-grafted coronary arteries 5 years after coronary artery bypass surgery.
Department of Medicine, Turku University Hospital, Turku, Finland.
K
K
Korpilahti
M
M
Syvänne
E
E
Engblom
H
H
Hämäläinen
P
P
Puukka
T
T
Rönnemaa
D000328:Adult; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014280:Triglycerides / Q000097:blood
D014280:Triglycerides; D002784:Cholesterol