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Titolo:
Metabolic abnormalities characteristic of dysmetabolic syndrome predict the development of transplant coronary artery disease - A prospective study
Autore:
Valantine, H; Rickenbacker, P; Kemna, M; Hunt, S; Chen, YDI; Reaven, G; Stinson, EB;
Indirizzi:
Stanford Univ, Sch Med, Div Cardiovasc Med, Stanford, CA 94305 USA Stanford Univ Stanford CA USA 94305 ardiovasc Med, Stanford, CA 94305 USA Stanford Univ, Dept Cardiothorac Surg, Stanford, CA 94305 USA Stanford Univ Stanford CA USA 94305 iothorac Surg, Stanford, CA 94305 USA Stanford Univ, Div Endocrinol Gerontol & Metab, Stanford, CA 94305 USA Stanford Univ Stanford CA USA 94305 ontol & Metab, Stanford, CA 94305 USA
Titolo Testata:
CIRCULATION
fascicolo: 17, volume: 103, anno: 2001,
pagine: 2144 - 2152
SICI:
0009-7322(20010501)103:17<2144:MACODS>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTRAVASCULAR ULTRASOUND; INTRACORONARY ULTRASOUND; CARDIAC TRANSPLANTATION; HEART; RISK;
Keywords:
transplantation; atherosclerosis; insulin; hyperinsulinemia; hypertriglyceridemia;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
12
Recensione:
Indirizzi per estratti:
Indirizzo: Valantine, H Stanford Univ, Sch Med, Div Cardiovasc Med, 300 Pasteur Dr, Stanford, CA 94305 USA Stanford Univ 300 Pasteur Dr Stanford CA USA 94305 94305 USA
Citazione:
H. Valantine et al., "Metabolic abnormalities characteristic of dysmetabolic syndrome predict the development of transplant coronary artery disease - A prospective study", CIRCULATION, 103(17), 2001, pp. 2144-2152

Abstract

Background-This study examines the hypothesis that metabolic abnormalitiesof dysmetabolic syndrome are risk factors for transplant coronary artery disease (TxCAD). Methods and Results-Sixty-six patients without overt diabetes, 2 to 4 years after surgery, underwent intracoronary ultrasound (ICUS), measurement of plasma glucose and insulin after oral glucose (75 g), and fasting lipid andlipoproteins. TxCAD incidence by angiography or autopsy was prospectively determined during subsequent follow-up (8 years). Coronary artery intimal thickness (IT) and subsequent outcomes were compared in patients stratified as having "high" versus "low" plasma glucose (>8.9 mmol/L) and insulin (> 760 pmol/L) 2 hours after glucose challenge; and "abnormal" versus "normal" fasting lipid and lipoprotein concentrations as defined by the National Cholesterol Education Program. Patients with high glucose or insulin concentrations had greater IT: 0.38 +/-0.05 versus 0.22 +/-0.02 mm, P less than or equal to0.05, and 0.39 +/-0.05 versus 0.20 +/-0.02 mm, P less than or equal to0.1, respectively. Freedom from TxCAD was 56 +/- 11% versus 81 +/-6% (P <0.01) in patients with high versus low glucose and 57 +/- 10% versus 82 +/-7% (P <0.5) in patients with high versus low insulin. Actuarial survival was 60 +/- 12% versus 92 +/-5% (P <0.005) in patients with high versus low glucose and 72 +/-9% versus 88 +/-6% (P <0.05) in patients with high versus low insulin. Triglycerides and VLDL were higher and HDL was lower in patients with IT >0.3 mm than with IT less than or equal to0.3 mm. TxCAD incidencewas higher in patients with high plasma TG and VLDL and low HDL. Conclusions-These data suggest that insulin resistance plays a role in TxCAD.

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Documento generato il 19/01/20 alle ore 08:57:54