Hyperinsulinemia Impaired Coronary Collateral Circulation in Patients with Chronic Total Coronary Occlusion
Xiaoyi Zou, Ming Chen, Limin Sun, Qiang Tan Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Qinhuangdao, Hebei Province, People’s Republic of ChinaCorrespondence: Qiang Tan, Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, No. 258 of Wen...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-05-01
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| Series: | Diabetes, Metabolic Syndrome and Obesity |
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| Online Access: | https://www.dovepress.com/hyperinsulinemia-impaired-coronary-collateral-circulation-in-patients--peer-reviewed-fulltext-article-DMSO |
| _version_ | 1797823868114567168 |
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| author | Zou X Chen M Sun L Tan Q |
| author_facet | Zou X Chen M Sun L Tan Q |
| author_sort | Zou X |
| collection | DOAJ |
| description | Xiaoyi Zou, Ming Chen, Limin Sun, Qiang Tan Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Qinhuangdao, Hebei Province, People’s Republic of ChinaCorrespondence: Qiang Tan, Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, No. 258 of Wenhua Road, Qinhuangdao, Hebei Province, 066000, People’s Republic of China, Email qhdtanqiang@aliyun.comBackground and Objectives: Hyperinsulinemia impaired cardiovascular system and endothelial function in the population. The purpose of this study was to explore the relationship between hyperinsulinemia and coronary collateral circulation in patients with chronic total coronary occlusion.Methods: Patients with stable angina and at least one total coronary occlusion were enrolled in this study. Collateral grade was determined according to Rentrop’s classification. Patients were divided into a good coronary collateral circulation (CCC) group (grade 2 or 3 collateral vessels, n = 223) and a poor CCC group (grade 0 or 1 collateral vessels, n = 115). Fasting insulin level (FINS) and fasting glucose level (FBS) were measured. Endothelial function evaluated by flow-mediated dilation (FMD).Results: Serum FINS level was significantly increased in the poor CCC group (P < 0.01). Patients in the poor CCC group had higher levels of FBS, HbA1C, and homeostasis model assessment for insulin resistance (HOMA-IR) than patients in the good CCC group. The poor CCC group also had lower levels of FMD, lower LVEF and higher syntax scores than the good CCC group. Hyperinsulinemia (T3, FINS ≥ 15.22 μIU/mL) increased OR for the incidence of the poor CCC group (OR 2.419, 95% CI 1.780– 3.287) in multivariate analysis. Multivariate logistic regression also revealed that diabetes, HbA1c, HOMA-IR, HDL-C and Syntax score were independent predictors of poor CCC (all P < 0.05).Conclusion: Hyperinsulinemia is a valuable predictor of poor collateral formation in patients with chronic total coronary occlusion.Keywords: coronary collateral, hyperinsulinemia, arteriogenesis, endothelial function |
| first_indexed | 2024-03-13T10:30:23Z |
| format | Article |
| id | doaj.art-d4589c0594a848bd8dc58c0f6b1454a1 |
| institution | Directory Open Access Journal |
| issn | 1178-7007 |
| language | English |
| last_indexed | 2024-03-13T10:30:23Z |
| publishDate | 2023-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Diabetes, Metabolic Syndrome and Obesity |
| spelling | doaj.art-d4589c0594a848bd8dc58c0f6b1454a12023-05-18T18:42:34ZengDove Medical PressDiabetes, Metabolic Syndrome and Obesity1178-70072023-05-01Volume 161425143383832Hyperinsulinemia Impaired Coronary Collateral Circulation in Patients with Chronic Total Coronary OcclusionZou XChen MSun LTan QXiaoyi Zou, Ming Chen, Limin Sun, Qiang Tan Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, Qinhuangdao, Hebei Province, People’s Republic of ChinaCorrespondence: Qiang Tan, Department of Cardiology, Qinhuangdao First Hospital, Hebei Medical University, No. 258 of Wenhua Road, Qinhuangdao, Hebei Province, 066000, People’s Republic of China, Email qhdtanqiang@aliyun.comBackground and Objectives: Hyperinsulinemia impaired cardiovascular system and endothelial function in the population. The purpose of this study was to explore the relationship between hyperinsulinemia and coronary collateral circulation in patients with chronic total coronary occlusion.Methods: Patients with stable angina and at least one total coronary occlusion were enrolled in this study. Collateral grade was determined according to Rentrop’s classification. Patients were divided into a good coronary collateral circulation (CCC) group (grade 2 or 3 collateral vessels, n = 223) and a poor CCC group (grade 0 or 1 collateral vessels, n = 115). Fasting insulin level (FINS) and fasting glucose level (FBS) were measured. Endothelial function evaluated by flow-mediated dilation (FMD).Results: Serum FINS level was significantly increased in the poor CCC group (P < 0.01). Patients in the poor CCC group had higher levels of FBS, HbA1C, and homeostasis model assessment for insulin resistance (HOMA-IR) than patients in the good CCC group. The poor CCC group also had lower levels of FMD, lower LVEF and higher syntax scores than the good CCC group. Hyperinsulinemia (T3, FINS ≥ 15.22 μIU/mL) increased OR for the incidence of the poor CCC group (OR 2.419, 95% CI 1.780– 3.287) in multivariate analysis. Multivariate logistic regression also revealed that diabetes, HbA1c, HOMA-IR, HDL-C and Syntax score were independent predictors of poor CCC (all P < 0.05).Conclusion: Hyperinsulinemia is a valuable predictor of poor collateral formation in patients with chronic total coronary occlusion.Keywords: coronary collateral, hyperinsulinemia, arteriogenesis, endothelial functionhttps://www.dovepress.com/hyperinsulinemia-impaired-coronary-collateral-circulation-in-patients--peer-reviewed-fulltext-article-DMSOcoronary collateralhyperinsulinemiaarteriogenesisendothelial function |
| spellingShingle | Zou X Chen M Sun L Tan Q Hyperinsulinemia Impaired Coronary Collateral Circulation in Patients with Chronic Total Coronary Occlusion Diabetes, Metabolic Syndrome and Obesity coronary collateral hyperinsulinemia arteriogenesis endothelial function |
| title | Hyperinsulinemia Impaired Coronary Collateral Circulation in Patients with Chronic Total Coronary Occlusion |
| title_full | Hyperinsulinemia Impaired Coronary Collateral Circulation in Patients with Chronic Total Coronary Occlusion |
| title_fullStr | Hyperinsulinemia Impaired Coronary Collateral Circulation in Patients with Chronic Total Coronary Occlusion |
| title_full_unstemmed | Hyperinsulinemia Impaired Coronary Collateral Circulation in Patients with Chronic Total Coronary Occlusion |
| title_short | Hyperinsulinemia Impaired Coronary Collateral Circulation in Patients with Chronic Total Coronary Occlusion |
| title_sort | hyperinsulinemia impaired coronary collateral circulation in patients with chronic total coronary occlusion |
| topic | coronary collateral hyperinsulinemia arteriogenesis endothelial function |
| url | https://www.dovepress.com/hyperinsulinemia-impaired-coronary-collateral-circulation-in-patients--peer-reviewed-fulltext-article-DMSO |
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