LBODP047 Correlation Of Insulin Resistance And Short-term Outcome In Non-diabetic Patients With St Segment Elevation Myocardial Infarction

Abstract

Abstract Background Obviously, hyperglycemia and insulin resistance (IR) are common in patients with ST-segment elevation myocardial infarction (STEMI) in the hospital, and they are connected to poor clinical outcomes. Additionally, insulin resistance is a substantial risk factor for cardiovascular diseases. The case of acute myocardial infarction likewise has a bleak prognosis. The study aimed to evaluate the association between IR and short-term outcomes of acute STEMI patients without diabetes mellitus in the form of reperfusion success, the occurrence of heart failure, development of arrhythmias, and mortality. Method: A cross-sectional study was done from August 2021 to December 2021 in two cardiology centers in Al-Sadr teaching hospital and Basrah oil hospital in Basrah, southern Iraq. Sixty-one nondiabetic hospitalized patients with acute STEMI were included in the study. Clinical data were collected by direct interview with the patients, 25(41%) of them received thrombolytics and 36 (59%) were managed with percutaneous transluminal coronary angioplasty. From each patient, a fasting blood sample was taken for glucose, triglyceride, and insulin to measure IR in the form of the homeostasis model assessment for IR (HOMA-IR) and triglyceride glucose index (TyG index). Both measures were grouped into three tertiles, for HOMA-IR (tertile 1 < 2.5, tertile 2 2.5 - <5, and tertile 3 ≥5) and for TyG index (tertile 1 <4.73, tertile 2 4.73 - <4.87, and tertile 3 ≥4.87). The patients were evaluated within 1-week for (reperfusion success, echocardiography for calculation of the ejection fraction (EF), arrhythmias, and mortality), and within 4-weeks for mortality. Results Within the tertile 3 of HOMA-IR, the patients were significantly more likely to have EF < 55% (35%), and higher 4-weeks mortality (35%). Also for the TyG index and within the tertile 3 (≥ 4.87), there was a significantly higher 4-weeks mortality (30%). Pearson correlation also showed significant and negative correlations between both HOMA-IR and TyG index values and EF. While reperfusion success, arrhythmias, and 1-week mortality did not correlate significantly with both HOMA-IR and TyG index. Conclusion Insulin resistance as defined by HOMA-IR and TyG index was significantly associated with poor outcomes in patients with acute STEMI in the form of EF<55 and 4-weeks mortality. Presentation: No date and time listed