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Components of the insulin resistance syndrome are associated with progression of atherosclerosis in non-grafted arteries 5 years after coronary artery bypass surgery |
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| Authors: | Korpilahti, K. Syvanne, M. Engblom, E. Hamalainen, H. Puukka, P. Ronnemaa, T. |
| Affiliation: | a Department of Medicine, Turku University Hospital, Turku b Department of Medicine, Division of Cardiology, Helsinki University Hospital, Helsinki c Research and Development Centre of the Social Insurance Institution, Turku, Finland |
| Abstract: | Aims Risk factors for progression of atherosclerosis in non-graftedcoronary arteries were examined in a prospective 5-year follow-upstudy of 228 consecutive coronary artery bypass surgery patients,with the main emphasis on insulin resistance syndrome. Methods and Results Serum lipids and lipoproteins were measured pre-operativelyand 1, 2, 3 and 5 years after surgery; and a baseline oral glucosetolerance test with plasma insulin determinations was performedpre-operatively. Progression of atherosclerosis was assessedby means of computer-based quantitative coronary angiography.Compared to subjects without progression, the patients withprogression of atherosclerotic lesions had a higher body massindex both at baseline (P=0·022) and at 5 years (P=0·007),were more often treated for hyper-tension at baseline (P=0·008)and at 5 years (P=0·012), used diuretics more often duringthe follow-up period (P=0·002), had a larger blood glucosearea under the curve (P=0·015) and a lower insulin sensitivityindex (P=0·006) in the baseline oral glucose tolerancetest, had a higher serum total cholesterol concentration atbaseline (P=0·044), and a higher serum triglyceride concentration(P=0·005) during the whole follow-up period. Clusteringof the components of insulin resistance syndrome at baselinewas more frequently found in patients with progression of atheroscleroticlesions than in patients without progression (P=0·025).For example, for patients with  1 component, the risk of progressionwas 17%, while for patients with  5 components the risk was 67%.As compared to the other patients, those with new atheroscleroticlesions had a lower insulin sensitivity index at baseline (P=0·033),and a lower serum high density lipoprotein cholesterol concentrationduring the follow-up period (P=0·033). Conclusion In addition to high serum cholesterol, the components of theinsulin resistance syndrome are associated with progressionof atherosclerosis in non-grafted coronary arteries 5 yearsafter coronary artery bypass surgery |
| Keywords: | Atherosclerosis coronary bypass surgery triglycerides insulin resistance |
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