Core Concepts
Insulin resistance score predicts post-CABG risk.
Abstract
The study focuses on the relationship between the metabolic score for insulin resistance (METS-IR) and major adverse cardiac events (MACE) in patients following coronary artery bypass graft (CABG) surgery.
Key Takeaways
Higher METS-IR linked to increased MACE risk post-CABG.
METS-IR offers risk stratification independent of traditional factors.
First study to explore METS-IR and MACE post-CABG.
Study Design
Retrospective analysis of 1100 CABG patients in China.
METS-IR calculated using fasting glucose, triglycerides, BMI, and HDL.
MACE defined as composite outcome including death, MI, PCI, CABG, or stroke.
Key Results
Patients in highest METS-IR quartile had 97% higher MACE risk.
Each SD increase in METS-IR raised MACE risk by 36%.
Addition of METS-IR improved MACE prediction post-CABG.
Limitations
Retrospective nature limits causal inference.
Bias possible due to telephone follow-up for MACE rates.
Lack of METS-IR measurements at multiple time points.
Stats
Patients in the highest METS-IR quartile had a significant 97% higher risk of MACE during follow-up compared with those in the lowest METS-IR quartile after adjusting for potential confounders.
Foreach standard deviation increase in METS-IR score the MACE risk increased by a significant 36% after full adjustment.
Adding METS-IR to traditional risk factors for cardiovascular disease significantly improved MACE prediction following CABG surgery, raising the C-statistic for MACE prediction with full adjustment from 0.702 without METS-IR to 0.720 with METS-IR.
Quotes
"CABG is standard treatment for people with multivessel and left main coronary artery disease and significantly improves cardiovascular outcomes, but long-term survival after CABG remains poor."
"The results suggest that METS-IR is a simple and reliable measure for risk stratification and to guide early interventions for patients who have undergone CABG surgery."