Insulin Resistance Indices and Coronary Artery Disease

Predicting the Presence and Severity of Coronary Artery Disease Using Surrogate Markers of Insulin Resistance: A Cross-Sectional Study

In this retrospective study from professor Kojuri clinic registry, total number of 1017 patients with first angiography were included and all data were recorded from registry. Insulin resistance was calculated using laboratory data

Study Overview

• Status: Completed
• Conditions: Coronary Artery Disease; Insulin Resistance
• Intervention / Treatment: Diagnostic test: triglyceride to glucose ratio; Diagnostic test: triglycerdie to HDL ratio

Detailed Description

This was an analytical cross-sectional retrospective study involving patients with suspected CAD who underwent coronary angiography between December 2018 and May 2023. The information was obtained from patients referred to the outpatient cardiovascular clinic (Professor Kojuri Cardiology Clinic, Shiraz, Iran, www.kojuriclinic.com). Data was extracted from Professor Kojuri Cardiology Clinic database, including patient's information about the clinical history, presence or absence of specific diseases, angiography/angioplasty results, medications, and laboratory values.

A total of 14,708 patients who had undergone coronary angiography at least once were examined. After applying exclusion criteria, 1017 eligible cases were selected for data analysis.

The following data was recorded for the included patients: demographic data, past medical history (such as DM, hypertension, etc.), systolic and diastolic blood pressure, weight and height, fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and serum creatinine (Cr). Body mass index (BMI) was calculated as weight (Kg) divided by the square of height (m2). Obesity was defined as BMI ≥ 30 Kg/m2.

Laboratory values were selected from the time before angiography, and if not available, from the time shortly after the angiography. This helped us find those values which could best represent the metabolic state of patients at the time of angiography, while reducing the confounding effect of statin use.

• Study Type: Observational
• Enrollment (Actual): 1017

Contacts and Locations

Study Locations

• Iran, Islamic Republic of
  • Fars
    • Shiraz, Fars, Iran, Islamic Republic of, 7134814336
      • Shiraz University of Medical Sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

Patients more than 18 years old referred for evaluation of coronary artery disease for their first time

Description

Inclusion Criteria:

• patients with age more than 18 years and having undergone coronary angiography

Exclusion Criteria:

• incomplete data
• history of prior coronary angiography or revascularization (percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG))
• serum creatinine > 1.4 mg/dL
• history of chronic kidney disease (CKD)
• cancer,

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
coronary artery disease; patients with coronary angiography of at least one vessel with more than 50% stenosis	Diagnostic test: triglyceride to glucose ratio; Ratio of triglyceride level to glucose; Diagnostic test: triglycerdie to HDL ratio; Ratio of triglyceride to HDL cholesterol
no coronary artery disease; patient with no stenosis in coronary angiography	Diagnostic test: triglyceride to glucose ratio; Ratio of triglyceride level to glucose; Diagnostic test: triglycerdie to HDL ratio; Ratio of triglyceride to HDL cholesterol

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
insulin resistance index: level of triglyceride to glucose ratio from blood sample	correlation of coronary artery disease and triglyceride glucose ratio in blood laboratory tests	3 years
insulin resistance index: Level of triglyceride to HDL ratio from blood sample	correlation of coronary artery disease and triglyceride to HDL level ratio in blood laboratory sample	3 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
metabolic syndrome	metabolic syndrome based on criteria of metabolic syndrome	3 years

Collaborators and Investigators

• Sponsor: Shiraz University of Medical Sciences
• Investigators: Principal Investigator: Javad Kojuri, MD. MS., professor Kojuri cardiology clinic

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2018
• Primary Completion (Actual): May 1, 2023
• Study Completion (Actual): September 1, 2023

Study Registration Dates

• First Submitted: January 23, 2024
• First Submitted That Met QC Criteria: January 23, 2024
• First Posted (Actual): February 1, 2024

Study Record Updates

• Last Update Posted (Actual): February 5, 2024
• Last Update Submitted That Met QC Criteria: February 2, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: coronary artery disease; insulin resistance; triglyceride glucose index
• Additional Relevant MeSH Terms: Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Glucose Metabolism Disorders; Metabolic Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Hyperinsulinism; Coronary Artery Disease; Myocardial Ischemia; Coronary Disease; Insulin Resistance
• Other Study ID Numbers: IR.SUMS.MED.REC.1402.252

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Data are available based on rational request

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No