title: [Impact of insulin resistance on prognosis in non-diabetic patients with acute coronary syndromes].
abstract: OBJECTIVE
  To evaluate the impact of insulin resistance (IR) on prognosis in non-diabetic acute coronary syndrome patients.
  
  
  METHODS
  In this prospective study, we enrolled 332 non-diabetic patients suffering from acute coronary syndrome. The patients were divided into three groups by HOMA-IR which calculated by formula: low HOMA-IR group (HOMA-IR < 2), 44 cases; moderate HOMA-IR group (2 ≤ HOMA2-IR < 6), 99 cases; high HOMA-IR group (HOMA ≥ 6) with HOMA index, 179 cases. The in-hospital medical records of patients were compared, and all patients were followed up for one year after discharge.
  
  
  RESULTS
  Incidence of hypertension (P = 0.013), dyslipidemia (P < 0.001), faster resting heart rate (P < 0.001) and number of triple vessel coronary artery disease (P = 0.017) in high HOMA-IR group were significantly higher than in low and moderate HOMA-IR group. During follow-up, the major end-point events increased in proportion to IR grade: 64.3% (26/44) in the high HOMA-IR group, 54.7% (52/99) in moderate HOMA-IR group and 41.3% (74/199) in low HOMA-IR group (P = 0.034). Multivariable logistic regression analysis showed that high sensitivity C reactive protein (OR = 1.012, 95%CI:1.002-1.022, P = 0.022), HOMA-IR (OR = 1.250, 95%CI:1.043-1.497, P = 0.015) , triple vessel coronary artery disease (OR = 5.914, 95%CI:2.947-11.868, P < 0.001) , ischemic changes on ECG (OR = 5.495, 95%CI:2.925-10.324, P < 0.001) and low left ventricular ejection fraction (LVEF ≤ 40%) (OR = 13.205, 95%CI:5.000-34.661, P < 0.001) were independent risk factor for major end-point events during follow-up.
  
  
  CONCLUSIONS
  Increased insulin resistance is linked with poor prognosis of non-diabetic patients with acute coronary syndrome.
authors.affiliation: Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120 China. Email:nieruqiong@126.com.
authors.forename: Ru-qiong
authors.initials: RQ
authors.lastname: Nie
authors.forename: Jia-rong
authors.initials: JR
authors.lastname: Liu
authors.forename: Bing-qing
authors.initials: BQ
authors.lastname: Deng
authors.forename: Shuang-lun
authors.initials: SL
authors.lastname: Xie
authors.forename: Jing-feng
authors.initials: JF
authors.lastname: Wang
mesh_terms: D054058:Acute Coronary Syndrome; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies