Introduction: In this study, we sought to determine whether insulin resistance, which is investigated by homeostatic modelling, is related to slow coronary flow (SCF).Materials and Methods: A total of 24 patients with SCF (4 females/20 males, mean age 47 ± 12 years) and 32 patients with normal coronary artery (10 females/22 males, mean age 52 ± 12 years) were included in the study. Baseline glucose, insulin and plasma lipid levels were measured. A standard oral glucose tolerance test (OGTT) was performed and post-challenge insulin levels were also measured. The index of insulin resistance was calculated with the homeostatic modelling [homeostatic model assessment for insulin resistance index (HOMA-IR)]. Results: There were no differences between the 2 groups with regard to age, lipid levels, blood pressure levels, history of smoking, fasting and post-challenge plasma glucose. Baseline insulin levels were augmented in the SCF group (9.64 ± 5.93 vs 7.04 ± 3.26, P = 0.041). HOMA-IR levels were not different between the study groups (2.20 ± 1.44 vs 1.69 ± 0.86, P = 0.129). Manifest insulin resistance was significantly higher in the CSF group as compared with the control group (25% vs 3%, P = 0.01). Conclusion: Manifest insulin resistance is seen more frequently in patients with SCF.
Slow coronary flow (SCF) is a well recognised clinical entity, characterised by delayed opacification of coronary arteries in the presence of normal coronary angiogram. Many aetiological factors, such as microvascular and endothelial dysfunction, have been implicated.
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.