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Homeostasis Model Assessment of Insulin Resistance and Survival in Patients With Diabetes and Acute Coronary Syndrome
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Stahli, B. E. (författare)
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Nozza, A. (författare)
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Schrieks, I. C. (författare)
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visa fler...
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Buse, J. B. (författare)
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Malmberg, K. (författare)
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- Mellbin, L. (författare)
- Karolinska Institutet
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Neal, B. (författare)
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Nicholls, S. J. (författare)
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- Ryden, L. (författare)
- Karolinska Institutet
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Svensson, A. (författare)
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- Wedel, Hans (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri,Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
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Weichert, A. (författare)
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Lincoff, A. M. (författare)
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Grobbee, D. E. (författare)
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Tardif, J. C. (författare)
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Schwartz, G. G. (författare)
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(creator_code:org_t)
- 2018-04-06
- 2018
- Engelska.
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Ingår i: Journal of Clinical Endocrinology & Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 103:7, s. 2522-2533
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Abstract
Ämnesord
Stäng
- Objective: Insulin resistance has been linked to development and progression of atherosclerosis and is present in most patients with type 2 diabetes. Whether the degree of insulin resistance predicts adverse outcomes in patients with type 2 diabetes and acute coronary syndrome (ACS) is uncertain. Design: The Effect of Aleglitazar on Cardiovascular Outcomes after Acute Coronary Syndrome in Patients with Type 2 Diabetes Mellitus trial compared the peroxisome proliferator-activated receptor-a/g agonist aleglitazar with placebo in patients with type 2 diabetes and recent ACS. In participants not treated with insulin, we determined whether baseline homeostasis model assessment of insulin resistance (HOMA-IR; n = 4303) or the change in HOMA-IR on assigned study treatment (n = 3568) was related to the risk of death or major adverse cardiovascular events (cardiovascular death, myocardial infarction, and stroke) in unadjusted and adjusted models. Because an inverse association of HOMA-IR with N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been described, we specifically examined effects of adjustment for the latter. Results: In unadjusted analysis, twofold higher baseline HOMA-IR was associated with lower risk of death [hazard ratio (HR): 0.79, 95% CI: 0.68 to 0.91, P = 0.002]. Adjustment for 24 standard demographic and clinical variables had minimal effect on this association. However, after further adjustment for NT-proBNP, the association of HOMA-IR with death was no longer present (adjusted HR: 0.99, 95% CI: 0.83 to 1.19, P = 0.94). Baseline HOMA-IR was not associated with major adverse cardiovascular events, nor was the change in HOMA-IR on study treatment associated with death or major adverse cardiovascular events. Conclusions: After accounting for levels of NT-proBNP, insulin resistance assessed by HOMA-IR is not related to the risk of death or major adverse cardiovascular events in patients with type 2 diabetes and ACS.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Nyckelord
- natriuretic peptide levels
- acute myocardial-infarction
- beta-cell
- function
- cardiovascular events
- glucose-tolerance
- artery-disease
- adipose-tissue
- increased risk
- heart-failure
- mellitus
- Endocrinology & Metabolism
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Stahli, B. E.
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Nozza, A.
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Schrieks, I. C.
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Buse, J. B.
-
Malmberg, K.
-
Mellbin, L.
-
visa fler...
-
Neal, B.
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Nicholls, S. J.
-
Ryden, L.
-
Svensson, A.
-
Wedel, Hans
-
Weichert, A.
-
Lincoff, A. M.
-
Grobbee, D. E.
-
Tardif, J. C.
-
Schwartz, G. G.
-
visa färre...
- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Hälsovetenskap
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och Folkhälsovetensk ...
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Journal of Clini ...
- Av lärosätet
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Göteborgs universitet
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Karolinska Institutet