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Mean platelet volume and its relation to insulin resistance in non-diabetic patients with slow coronary flow
Islam A Elsherbiny1, Amira Shoukry, Mohammad A El Tahlawi
1Cardiology Department, Zagazig University Hospital, Zagazig, Egypt. islamcardio@yahoo.com
Insights
Increased mean platelet volume and insulin resistance are linked in non-diabetic patients with slow coronary flow. These factors may play a role in the condition
Area of Science:
- Cardiology
- Metabolic Syndrome
- Hematology
Background:
- Increased mean platelet volume is implicated in coronary heart disease.
- Insulin resistance is associated with heightened platelet activation.
Purpose of the Study:
- To investigate mean platelet volume (MPV) and its association with insulin resistance.
- Focus on non-diabetic patients experiencing slow coronary flow (SCF).
Main Methods:
- Compared 60 SCF patients with 20 controls.
- Assessed MPV and insulin resistance using Homeostasis Model Assessment of Insulin Resistance (HOMA-IR).
- Categorized SCF patients into insulin-resistant and insulin-sensitive groups.
Main Results:
- SCF patients exhibited significantly higher MPV, insulin levels, and HOMA-IR scores compared to controls.
- Insulin-resistant SCF patients had elevated MPV and HOMA-IR compared to insulin-sensitive SCF patients.
- MPV correlated positively with HOMA-IR and insulin levels; both were independent predictors of mean TIMI frame count.
Conclusions:
- Elevated MPV in SCF patients is associated with insulin resistance.
- Insulin resistance and platelet activity may contribute to SCF pathogenesis.
- MPV and HOMA-IR show potential as follow-up markers for non-diabetic SCF patients.
Background:
Increased mean platelet volume is a central process in the pathophysiology of coronary heart disease. Insulin resistance contributes to increased platelet activation.
Aim:
To assess the mean platelet volume and its possible relationship with insulin resistance in non-diabetic patients with slow coronary flow.
Methods And Subjects:
The study included 60 patients with slow coronary flow and 20 subjects (controls) with normal coronary arteries. Slow coronary flow patients were divided into 2 groups, insulin resistant (32 patients) and insulin sensitive (28 patients) according to the homeostasis model assessment of insulin resistance index (HOMA-IR).
Results:
Patients with slow coronary flow had significantly higher mean platelet volume values (7.9±0.47 vs. 7.1±0.5, p<0.01), insulin level (10.8±3.2 vs. 8.2±1.4, p<0.01), and HOMA-IR scores (2.72±0.85 vs. 1.84±0.19, p<0.01). These parameters were significantly higher in insulin-resistant patients than in insulin-sensitive ones. The mean platelet volume was correlated with HOMA-IR (r=0.52, p<0.01) and insulin level (r=0.58, p<0.01). In multivariate analysis, mean platelet volume and HOMA-IR were independent predictors of mean TIMI frame count {(B±SE=0.562±2.95, p<0.01) and (B±SE=0.538±2.46, p<0.01), respectively}.
Conclusion:
Patients with slow coronary flow have increased mean platelet volume which was associated with insulin resistance in non-diabetic slow coronary flow patients. TIMI frame counts correlated with mean platelet volume and increased insulin resistance. Thus, insulin resistance and platelet activity may have a role in the pathogenesis of slow coronary flow. Also, they may have a possible benefit as follow-up markers in non-diabetic patients with slow coronary flow.
