Abstract 380: Gender Differences in Glucose Metabolism Profile in Patients with ST Segment Elevation Myocardial Infarction

Abstract

Background: Presence of insulin resistance has been known to be a strong independent risk factor for coronary artery disease. However, there is limited data on gender differences in metabolic profile of patients that present with an acute ST segment elevation myocardial infarction (STEMI). Methods: All patients (N = 1,652) who underwent primary PCI for STEMI at the Cleveland Clinic Foundation between January 2005 to December 2012 were included. Insulin Resistance (IR) was defined as presence of diabetes mellitus (DM) or pre-DM. Further DM was identified if there was a known history of DM or hypoglycaemic therapy or if admission glycated hemoglobin (HbA1c) was ≥ 6.5 and pre-DM was defined for admission HbA1c ≥ 5.7 and < 6.5. Lastly, prevalence of IR in women was compared with similarly aged men presenting with STEMI at our institution. Results: IR was identified in 70% (n= 1,163/1,652) and DM in 30% (n = 487/1,652) of patients presenting with STEMI. Prevalence of IR was significantly higher in post menopausal women (age > 50 years) when compared with similarly aged men (79%; 344/435 vs. 69%; 603/871; p <0.0001) with majority of the difference contributed by difference in incidence of DM (38%; 163/435 in females vs 29%; 257/871 in males; p<0.0001; Figure 1). Conclusions: Our results indicate that prevalence of IR including diabetes mellitus may be higher in women as compared to similarly aged men who present with STEMI and the difference increases with increasing age. We also noted that Pre-DM contributes significantly to the high prevalence of IR in subjects with STEMI irrespective of gender. Larger studies are required to assess the impact of Pre-DM on adverse cardiovascular events in men as well as women.