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Comparative association study of different insulin resistance assessors with all-cause mortality among a Portuguese population
Session:
Sessão de Posters 56 - Risco metabólico e lipoproteínas na doença coronária
Speaker:
Matilde Ferreira
Congress:
CPC 2026
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
12. Coronary Artery Disease (Chronic)
Subtheme:
12.2 Coronary Artery Disease – Epidemiology, Prognosis, Outcome
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Matilde Ferreira; M.I. Mendonça; G. Abreu; F. Sousa; F. Escórcio Silva; M. Rodrigues; S. Freitas; E. Henriques; S. Borges; A. Drumond; A. C. Sousa; R. Palma Dos Reis
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> Atherosclerotic cardiovascular diseases with cardiometabolic conditions have a high prevalence of comorbidities and an elevated mortality risk. Insulin resistance (IR) is a significant contributor to their pathogenesis. METS-IR (</span></span>Metabolic Score) <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">assessors for IR are employed in clinical evaluations; however, their relationship with all-cause mortality is poorly understood.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Objective</strong>: To investigate the association between the METS-IR, a marker of Insulin resistance, and all-cause mortality in patients with established atherosclerotic cardiovascular disease.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods: </strong>A cohort study was performed with 1,720 cardiovascular patients with (78.8% were male; mean age of 53.3±7.9 years) with cardiometabolic conditions with an extended follow-up (average 7.6±6.7 years). The IR levels were assessed using a surrogate marker METS-IR=[ln[2xfasting plasma glucose (FPG)+ triglycerides (TG)]x body mass index (BMI)]/ln[HDL-cholesterol (HDL-C)]. To investigate the associations between this marker and all-cause mortality, multivariable Cox proportional hazards models were applied. We employed restricted cubic splines (RCS) to examine nonlinear associations. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> Of the 1,720 patients with cardiovascular disease, 550 deaths from all causes were registered. The METS-IR threshold value for all-cause mortality was 49.4. When values exceeded this threshold, it demonstrated a positive correlation with all-cause mortality (HR 1.222; 95% CI: 1.020–1.465; p=0.030), along with age (HR=1.040; p<0.0001), smoking (HR=1.416; p<0.0001) and diabetes (HR=1.256; p=0.012). The RCS graph showed a non-linear association between METS-IR and all-cause mortality, with lower risk at low METS-IR levels but a gradual increase that becomes pronounced at higher METS-IR levels.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion</strong>: METS-IR was significantly associated with all-cause mortality, highlighting its value as<span style="background-color:white"><span style="color:#0a0a0a"> a prognostic marker for identifying high-risk individuals within cardiometabolic populations. </span></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Identifying a threshold METS-IR may serve as a target for preventive interventions and reduce the risk of premature death.</span></span></p>
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