title: [The association of insulin resistance, blood pressure variability and severity of acute coronary syndrome].
abstract: OBJECTIVE
  To investigate the association of insulin resistance (IR), blood pressure variability (BPV) and the severity of acute coronary syndrome (ACS), and assess the effect of percutaneous coronary intervention (PCI) on recent prognosis.
  
  
  METHODS
  A total of 260 patients diagnosed as ACS and hospitalized in our department of cardiology from December 2009 to December 2010 were enrolled in the study. There were 93 cases of unstable angina pectoris(UAP), 84 of non ST segment elevation myocardial infarction and 83 of unstable angina pectoris. The subjects were divided into two groups according to 24 hour systolic blood pressure coefficient of variability (24 h SBP-CV) levels: high-CV group (24 h SBP-CV > 11.5, n = 130) and low-CV group(24 h SBP-CV < 11.5, n = 130). The differences in HOMA-IR and the severity of coronary artery diseases between the two groups were compared. The association of major adverse cardiac events within 6 months after PCI treatment, and IR as well as BPV was analyzed.
  
  
  RESULTS
  Compared with the low-CV group, ACS patients in the high-CV group had obviously higher HOMA-IR levels (5.7 ± 1.2 vs 4.0 ± 1.4, P < 0.01), more multivessel diseases (49.2% vs 33.3%, P < 0.05) and B2/C type coronary diseases (48.5% vs 27.7%, P < 0.01), and higher coronary Gensini scores (59.7 ± 17.5 vs 43.8 ± 18.6, P < 0.01). Multi-factors logistic regression analysis indicated that both 24 h BPV-CV and IR were independent predictors for MACE incidence within 6 months after undergone PCI (P < 0.05 or P < 0.01).
  
  
  CONCLUSIONS
  IR and BPV were obviously associated with the severity of coronary artery diseases in ACS patients. IR and 24 h BPV-CV were valuable in predicting recent prognosis of ACS patients.
authors.affiliation: Department of Cardiology, Guangzhou First People's Hospital, Guangzhou, China. lishaonan1977@163.com
authors.forename: Shao-nan
authors.initials: SN
authors.lastname: Li
authors.forename: Yi
authors.initials: Y
authors.lastname: Luo
authors.forename: Guang-lian
authors.initials: GL
authors.lastname: Li
authors.forename: Hui-fang
authors.initials: HF
authors.lastname: Huang
authors.forename: Ping-an
authors.initials: PA
authors.lastname: Chen
authors.forename: Zhen
authors.initials: Z
authors.lastname: Liu
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology*; D000368:Aged; D062186:Arterial Pressure; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011379:Prognosis