title: Insulin resistance as a predictor for restenosis after coronary stenting.
abstract: OBJECTIVE
  The rationale of this study was to determine whether insulin resistance is an independent risk factor for restenosis after coronary stenting.
  
  
  BACKGROUND
  Previous studies suggested that hyperinsulinemia may be an important risk factor for ischemic heart disease. Restenosis after coronary stenting is neointimal tissue proliferation and de-novo stenosis is atherosclerosis from the point of view of histology. However, it has not been determined whether insulin resistance is independently related to restenosis after coronary stenting.
  
  
  METHODS
  Clinical variables of unselected population of 110 patients were analyzed in multivariate logistic regression analyses for both restenosis and de-novo stenosis. Clinical, lesion-related, and procedural variables were analyzed by chi-square analysis, and relative risk.
  
  
  RESULTS
  Multivariate logistic regression analysis showed that homeostasis model assessment insulin resistance (HOMA-IR) and HbA1c were associated with restenosis after coronary stenting (HOMA-IR; P=0.0447, HbA1c; P=0.0462), and HbA1c and low-density lipoprotein cholesterol (LDL-C) were associated with de-novo stenosis (HbA1c; P=0.0201, LDL-C; P=0.0204). Restenosis was influenced by insulin resistance [Relative Risk (RR) 2.06; 95 percent confidence interval (95%CI) 1.20 to 3.56], diabetes mellitus (DM: RR 1.92; 95%CI 1.25 to 2.95), and final minimal lumen diameter (RR 2.83; 95%CI 1.32 to 6.06).
  
  
  CONCLUSIONS
  HOMA-IR and DM are the predictors of restenosis after coronary stenting, and HbA1c and LDL-C are the predictors of de-novo stenosis. These results may be reflected in histological differences between neointimal tissue proliferation as restenosis and atherosclerosis as de-novo stenosis.
authors.affiliation: The Third Department of Internal Medicine, School of Medicine Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan. kazukun@jg7.so-net.ne.jp
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Nishio
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Fukui
authors.forename: Fumiyoshi
authors.initials: F
authors.lastname: Tsunoda
authors.forename: Kitaro
authors.initials: K
authors.lastname: Kawamura
authors.forename: Seiji
authors.initials: S
authors.lastname: Itoh
authors.forename: Noburu
authors.initials: N
authors.lastname: Konno
authors.forename: Kou
authors.initials: K
authors.lastname: Ozawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Katagiri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D019917:Blood Vessel Prosthesis Implantation; D023903:Coronary Restenosis / Q000097:blood / Q000378:metabolism*; D023921:Coronary Stenosis / Q000378:metabolism / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers