We investigated the relationship between fasting plasma insulin levels and the severity of angiographic coronary artery disease(CAD).
Fasting plasma insulin levels were obtained in 51 men and 31 women, mean age 60 years, with an increased body mass index who underwent coronary angiography for suspected symptomatic CAD.
Of 82 patients, 37 (45%) had left main or 3-vessel CAD, 22 (27%) had 2-vessel CAD, 9 (11%) had 1-vessel CAD, and 14 (17%) had no obstructive CAD. Among the 4 groups, there was no significant difference in gender, age, dyslipidemia, and smoking. Hypertension (p=0.0003), diabetes mellitus (p=0.035), and increased fasting plasma insulin level (p<0.0001) were significantly associated with the severity of CAD. Stepwise ordinal regression analysis identified increased fasting plasma insulin level as a significant independent risk factor for the severity of CAD (p<0.0001).
Increased fasting plasma insulin level is a significant independent risk factor for the severity of angiographic CAD.
Patients with increasedf fasting plasma insulin levels should be treated aggressively with risk factor modification.
R. Sukhija, None.