Insulin resistance and dysglycemia are associated with left ventricular remodeling after myocardial infarction in non-diabetic patients

Cardiovasc Diabetol. 2019 Aug 7;18(1):100. doi: 10.1186/s12933-019-0904-3.


Background: Adverse cardiac remodeling after ST-segment elevation myocardial infarction (STEMI) is a major cause for poor cardiovascular outcomes such as heart failure. The predisposing factors and underlying mechanisms remain not fully understood. This study investigates the association of insulin resistance and dysglycemia with left ventricular (LV) remodeling after STEMI in non-diabetic patients.

Methods: A total of 485 non-diabetic subjects with STEMI who underwent primary percutaneous coronary intervention were consecutively enrolled and followed up for 12 months. Relation of homeostasis model assessment-estimated insulin resistance (HOMA-IR) and glucose levels to changes in echocardiography parameters was studied.

Results: Left ventricular dilation was detected in 49.1% of subjects at 12-month follow-up after STEMI, and was more severe in subjects with impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and high HOMA-IR levels. HOMA-IR remained correlated to changes in LV dimensions after adjusting for confounding risk factors. Multivariate regression analysis demonstrated that higher HOMA-IR was independently associated with greater LV dilation after STEMI. A significant interaction term was present between HOMA-IR and IGT in the model (P = 0.001).

Conclusions: Our study reveals that insulin resistance and dysglycemia are prevalent in non-diabetic patients with STEMI and are predictors of the post-infarction LV dilation. Trial registration Trials number, NCT02089360; registered on March 17, 2014.

Keywords: Dysglycemia; Insulin resistance; Left ventricular dilation; Myocardial infarction; Remodeling.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / blood
  • Blood Glucose / metabolism*
  • China / epidemiology
  • Glucose Intolerance / blood*
  • Glucose Intolerance / diagnosis
  • Glucose Intolerance / epidemiology
  • Humans
  • Insulin Resistance*
  • Percutaneous Coronary Intervention* / adverse effects
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • ST Elevation Myocardial Infarction / diagnostic imaging
  • ST Elevation Myocardial Infarction / epidemiology
  • ST Elevation Myocardial Infarction / physiopathology
  • ST Elevation Myocardial Infarction / therapy*
  • Time Factors
  • Treatment Outcome
  • Ventricular Function, Left*
  • Ventricular Remodeling*


  • Biomarkers
  • Blood Glucose

Associated data