Hyperinsulinemia and its contribution to the clinical course and outcome of myocardial infarct. Data from a 5-year prospective study
Telkova, I.L.; Tepliakov, A.T.; Karpov, R.S.
Terapevticheskii Arkhiv 74(9): 20-25
2002
ISSN/ISBN: 0040-3660 PMID: 12418114 Document Number: 547930
Assessment of hyperinsulinemia (HIE) contribution to severity of clinical symptoms and outcomes of myocardial infarction (MI) as well as its further changes as shown by a 5-year follow-up. 112 men aged 47.5 +/- 0.8 years with recent Q-wave MI were examined. Coronary circulation, frequency of concomitant arterial hypertension (AH) and complications in acute MI, levels of insulin, hydrocortisone and somatotropin (radioimmunoassay) were studied in all the patients on MI day 21-26 (the subacute period) and during long-term follow-up with a control point of 5 years after MI onset. 60% of patients who died during 5 years after MI had HIE in the subacute period irrespective of AH presence. If MI was complicated by acute heart failure, HIE rate reached 70%. After 5 years of the follow-up, 70% of patients showed a decreased insulin level to < 13.5 mked/ml which went up under induced ischemia. An elevated level of insulin in postmyocardial infarction patients is caused by impaired coronary blood flow and myocardial metabolism, is a dynamic state and is compensatory. It is an unfavourable prognostic marker for survival especially in combination with hypercortisolemia. Hyperinsulinemia late after MI frequently is frequently associated with AH and is detected at induced myocardial ischemia.