title: Comparison of frequency of insulin resistance after coronary stenting in patients with type 2 diabetes mellitus with versus without coronary restenosis.
abstract: The large incidence of restenosis after coronary angioplasty in diabetic patients renders this procedure less effective than in nondiabetics, and insulin resistance could be a relevant cause of restenosis in such patients. This study assessed insulin resistance and biologic markers of metabolic control in type 2 diabetic patients treated with stented angioplasty. Seventy-four patients were studied prospectively. Biochemical determinations, insulin tolerance test results, and the rate constant for plasma glucose disappearance (K(itt)%) were obtained. The angiographic outcome of angioplasty was assessed by quantitative coronary analysis at baseline and at 6 months in 64 patients (86%). Patients with restenosis had smaller minimum luminal diameters after stenting (2.8 +/- 0.5 vs 3.04 +/- 0.5 mm, p = 0.05), were more often hypertensive (97% vs 79%, p = 0.02) and treated with angiotensin-converting enzyme inhibitors (53% vs 23%, p = 0.02), and had smaller K(itt)% (2.9 +/- 1.6%/min vs 3.7 +/- 1.4%/min, p = 0.04) and larger titers of growth hormone (1.36 +/- 1.5 vs 0.68 +/- 0.6 ng/ml, p = 0.02).
authors.affiliation: Department of Cardiovascular Diseases, Ospedale Santa Croce e Carle, Via Coppino 26, 12100 Cuneo, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Feola
authors.forename: Flavio
authors.initials: F
authors.lastname: Ribichini
authors.forename: Valeria
authors.initials: V
authors.lastname: Ferrero
authors.forename: Massimo
authors.initials: M
authors.lastname: Procopio
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Magro
authors.forename: Antonello
authors.initials: A
authors.lastname: Vado
authors.forename: Giorgio
authors.initials: G
authors.lastname: Borretta
authors.forename: Giacomo
authors.initials: G
authors.lastname: Boccuzzi
authors.forename: Corrado
authors.initials: C
authors.lastname: Vassanelli
authors.forename: Eugenio
authors.initials: E
authors.lastname: Uslenghi
mesh_terms: D000328:Adult; D000368:Aged; D017130:Angioplasty / Q000379:methods*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000628:therapy*; D023903:Coronary Restenosis / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D015607:Stents; D016896:Treatment Outcome