Hyperinsulinaemia is associated with increased long-term mortality following acute myocardial infarction in

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Charlotte Kragelund1, Ole Snorgaard, Lars Køber

  • 1Department of Cardiology and Endocrinology, Frederiksberg Hospital, University of Copenhagen, Nordre Fasanvej 57-59, DK-2000 Frederiksberg, Denmark. kragelund@dadlnet.dk

European Heart Journal
|November 4, 2004
PubMed

Insights

High fasting insulin levels independently predict mortality in non-diabetic patients after acute myocardial infarction. This finding suggests targeting insulin resistance may improve outcomes for these cardiac patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Syndrome

Background:

  • Acute myocardial infarction (AMI) poses significant mortality risks.
  • Glucose metabolism disturbances are increasingly recognized in cardiovascular disease.
  • The prognostic value of insulin resistance in non-diabetic AMI patients requires further clarification.

Purpose of the Study:

  • To investigate the association between glucose metabolism abnormalities and all-cause mortality in non-diabetic patients experiencing AMI.
  • To identify specific metabolic markers that predict mortality risk post-myocardial infarction.

Main Methods:

  • A cohort of 494 non-diabetic patients with verified myocardial infarction was analyzed.
  • Baseline measurements included fasting insulin, glucose, glycosylated hemoglobin (HbA1c), and urinary albumin.
  • Survival status was tracked for 6-8 years using regression analyses.

Main Results:

  • Higher levels of fasting insulin, glucose, HbA1c, and urinary albumin were associated with increased mortality risk in univariate analysis.
  • Only elevated fasting insulin remained a significant independent predictor of mortality in multivariable analysis (RR=1.54, p=0.04).
  • Patients with hyperinsulinemia exhibited higher rates of obesity, hypertension, and heart failure.

Conclusions:

  • Elevated fasting plasma insulin is an independent risk factor for all-cause mortality in non-diabetic patients with acute myocardial infarction.
  • These findings support the need for interventions targeting insulin resistance in this patient population.
  • Fasting insulin levels could serve as a valuable target for risk stratification and therapeutic strategies.
Abstract

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