Hyperinsulinemia as a risk factor for restenosis after coronary balloon angioplasty

The present study evaluated whether hyperinsulinemia is a predictor of rest enosis after coronary balloon angioplasty in 69 patients who underwent elec tive coronary balloon angioplasty; patients were excluded if they were know n diabetics being treated with insulin. Quantitative coronary angiography w as performed before and after angioplasty and at follow-up. Restenosis was defined as the presence of greater than or equal to 50% stenosis at follow- up. Plasma insulin responses before, 30, 60, and 120 min after 75 g glucose load (OGTF) were measured. Plasma insulin levels were higher in patients w ith restenosis than in patients without restenosis. Minimal lumen diameter at follow-up was smaller, and percent diameter stenosis at follow-up was hi gher and late loss was greater in the highest sum of insulin levels during OGTT (Sigma insulin) quartile (0.95 +/-0.15 vs 1.47 +/-0.09 mm, p=0.005; 66 .3 +/-5.8 vs 40.5 +/-3.3%, p=0.0003; 0.90 +/-0.15 vs 0.49 +/-0.08 mm, p=0.0 2). Even after adjustment for coronary risk factors and administration of a ngiotensin converting enzyme inhibitors, the association of hyperinsulinemi a with restenosis leads to the conclusion that hyperinsulinemia is a strong risk factor for restenosis.