Relationship Between Hyperinsulinemia and Coronary Microvascular Disease

Area of Science:

• Cardiology
• Endocrinology
• Vascular Biology

Background:

• Coronary microvascular disease (CMVD) is a frequent cause of chest pain, but its mechanisms are not fully understood.
• Hyperinsulinemia is increasingly recognized as a factor in cardiovascular dysfunction and may contribute to CMVD.
• This study investigates the association between hyperinsulinemia and CMVD in patients with chest pain.

Purpose of the Study:

• To examine the relationship between hyperinsulinemia and the presence of coronary microvascular disease (CMVD).
• To identify hyperinsulinemia as an independent predictor of CMVD in a clinical population.

Main Methods:

• 347 patients with ischemic chest pain and no obstructive coronary artery disease were studied.
• Coronary flow reserve (CFR) was assessed; CMVD was defined as CFR < 2.0.
• Fasting insulin, glucose, and HbA1c levels were measured, and patients were stratified by insulin tertiles. Multivariate logistic regression was used to determine risk factors.

Main Results:

• Patients with CMVD had higher fasting insulin, glucose, HOMA-IR, and HbA1c levels.
• Hyperinsulinemia (highest tertile of fasting insulin) was an independent predictor of CMVD (OR 2.279).
• Diabetes, female sex, hypertension, and age were also independent risk factors for CMVD.

Conclusions:

• Hyperinsulinemia is significantly associated with impaired coronary microvascular function.
• Hyperinsulinemia is an independent contributor to the development of CMVD, independent of traditional risk factors.