CORRELATION OF SEVERITY OF CORONARY ARTERY DISEASE WITH INSULIN RESISTANCE IN PATIENTS UNDERGOING CORONARY ANGIOGRAM
Main Article Content
Keywords
Coronary artery disease, insulin resistance, HOMA-IR, Gensini score, type 2 diabetes mellitus
Abstract
Diabetes mellitus is recognized as a major risk factor in the development of coronary artery disease (CAD). Insulin resistance (IR), which precedes and accompanies type 2 diabetes mellitus, has been suggested as a predictive marker for CAD severity. However, limited evidence is available linking IR with angiographic severity of CAD in the local population. The objective of this study was to evaluate the correlation between IR, measured using the HOMA-IR index, and the severity of CAD assessed by the modified Gensini score in patients undergoing coronary angiography.
Material & Methods:
This cross-sectional study was conducted at Department of Cardiology, PIC/ Quaid-e-Azam Medical College Bahawalpur, Pakistan over a six-month period. A total of 200 type 2 diabetic patients (age 35–75 years) undergoing coronary angiography were included. Insulin resistance was calculated using HOMA-IR. CAD severity was determined using the modified Gensini score. Chi-square test was applied to assess associations. P-value <0.05 was taken as statistically significant.
Results:
The mean age of the patients was 54.2±9.3 years, with 138 (69%) males and 62 (31%) females. The mean duration of diabetes was 8.1±6.2 years. The mean HOMA-IR score was 3.1±1.2. A significant positive correlation was observed between IR levels and CAD severity as assessed by the modified Gensini score (p<0.01). Patients with higher HOMA-IR scores had more severe, multi-vessel disease.
Conclusion:
Insulin resistance is strongly associated with the severity of coronary artery disease among type 2 diabetic patients. Measurement of HOMA-IR may be considered a useful, simple tool for risk stratification and early identification of patients at risk of severe CAD.
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Mudassar Iqbal
Assistant Professor, Department of Cardiology, Ch Pervaiz Elahi Institute of Cardiology, Multan, Pakistan
Muhammad Sarwar Khalid
Associate Professor, Department of Cardiology, PIC/ Quaid-e-Azam Medical College, Bahawalpur, Pakistan
Fouzia Goher
Assistant Professor, Department of Cardiology, PIC/ Quaid-e-Azam Medical College, Bahawalpur, Pakistan
Muhammad Umar Iqbal
Assistant Professor, Department of Cardiology, PIC/ Quaid-e-Azam Medical College, Bahawalpur, Pakistan
Asif Ali
Assistant Professor, Department of Cardiology, PIC/ Quaid-e-Azam Medical College, Bahawalpur, Pakistan
Urwah Imtiaz
Senior Registrar, Department of Cardiology, PIC/ Quaid-e-Azam Medical College, Bahawalpur, Pakistan