SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

Sie sind hier | Vous êtes ici:

T. Marte1 , C.H. Saely1 , S. Aczel1 , G. Hoefle2 , P. Langer1 , H. Drexel1

1Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria, 2Department of Internal Medicine, Academic Teaching Hospital Feldkirch, Feldkirch, Austria

Background: Patients with both diabetes and established coronary artery disease (CAD) are at a high risk of cardiovascular events. Insulin resistance (IR) is a central feature of diabetes mellitus type 2 (DM2). Therefore, the impact of IR on the incidence of vascular events in diabetic patients with established CAD is of particular interest.
Methods: We estimated insulin resistance by the HOMA index in 495 patients with angiographically proven CAD and recorded the incidence of vascular events over a mean follow-up time of 2.3 ± 0.4 years.
Results: The HOMA index was higher in coronary patients with DM2 (n = 127) than in nondiabetic coronary patients (6.5 ± 5.9 vs. 3.0 ± 4.2; p < 0.001). Thirty-one (23.8%) patients with DM 2 and 60 nondiabetic patients (14.5%) experienced at least 1 vascular event. In Cox regression analysis adjusting for age, gender, and baseline extent of coronary artery disease (number of angiographic stenoses 󖾦%) diabetes was an independent predictor for the incidence of vascular events (OR = 1.725 [1.116 – 2.667]; p = 0.014). Equally, the HOMA index proved independently predictive for the incidence of vascular events in the total study cohort: the standardized OR adjusted for age, gender, and baseline extent of CAD was 1.178 [1.026-1.351]; p = 0.010. In subgroup analyses with respect to diabetes status, the HOMA index was significantly predictive for vascular events in patients with diabetes (OR = 1.354 [1.083 – 1.694; p = 0.008]), but not among nondiabetic patients (OR = 1.022 [0.729 – 1.432]; p = 0.901).
Conclusions: In the setting of secondary prevention, IR is a strong and independent predictor of vascular events among patients with DM2. Thus, the degree of IR significantly contributes to the adverse effects of diabetes on the prognosis in coronary patients.


07. & 08.03.2019: Swiss eHealth Forum - Digitales Gesundheitswesen – Hope and > mehr


pipette 06/2018: Die Analyse der Darmflora | Analyse du microbiote

Aktuelle Ausgabe als E-Paper lesen


17.12.2018: Cheflaboranten/in 80%, (HFR) Tafers