title: Insulin Resistance as a Predictor of the Late Catch-up Phenomenon After Drug-Eluting Stent Implantation.
abstract: BACKGROUND
  Percutaneous coronary intervention (PCI) is an effective treatment for patients with ischemic heart disease. In particular, restenosis is suppressed after drug-eluting stent (DES) implantation. However, several problems remain. Previously, we reported neointimal proliferation after DES implantation, which was associated with insulin resistance (IR). The aim of the present study was to clarify whether IR is associated with mortality and major adverse cardiac and cerebrovascular events (MACCE) after 1st-generation DES implantation.
  
  
  RESULTS
  We researched the clinical records of 109 patients who had undergone elective PCI and DES implantation between May 2007 and December 2010. We segregated these patients according to the value of the homeostasis model assessment of IR (HOMA-IR) into Group P (n=63; HOMA-IR ≥2.5, positive) and Group N (n=46; HOMA-IR <2.5, negative), and examined the relationship between HOMA-IR and MACCE. The observation period was 7.4±1.6 years. There were no differences between the 2 groups in the occurrence of all-cause death, cardiac death, restenosis, myocardial infarction, stroke, heart failure, or stent thrombosis. However, the late catch-up phenomenon was significantly more common in Group P than in Group N (12.7% vs. 2.2% P=0.048).
  
  
  CONCLUSIONS
  IR is a useful predictor of the late catch-up phenomenon after DES implantation, and improvement of IR may help to prevent the phenomenon. (Circ J 2016; 80: 657-662).
authors.affiliation: Department of Cardiology, Dokkyo Medical University Koshigaya Hospital.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Komatsu
authors.forename: Sachiko
authors.initials: S
authors.lastname: Komatsu
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Nakamura
authors.forename: Takanori
authors.initials: T
authors.lastname: Kuroyanagi
authors.forename: Akinori
authors.initials: A
authors.lastname: Fujikake
authors.forename: Itaru
authors.initials: I
authors.lastname: Hisauchi
authors.forename: Masashi
authors.initials: M
authors.lastname: Sakuma
authors.forename: Shiro
authors.initials: S
authors.lastname: Nakahara
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Sakai
authors.forename: Isao
authors.initials: I
authors.lastname: Taguchi
mesh_terms: D000368:Aged; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000473:pathology; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000473:pathology / Q000601:surgery*; D058426:Neointima / Q000209:etiology / Q000473:pathology; D011237:Predictive Value of Tests