{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T02:32:59Z","timestamp":1776479579446,"version":"3.51.2"},"reference-count":38,"publisher":"The Endocrine Society","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Insulin resistance has been linked to development and progression of atherosclerosis and is present in most patients with type 2 diabetes. Whether the degree of insulin resistance predicts adverse outcomes in patients with type 2 diabetes and acute coronary syndrome (ACS) is uncertain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>The Effect of Aleglitazar on Cardiovascular Outcomes after Acute Coronary Syndrome in Patients with Type 2 Diabetes Mellitus trial compared the peroxisome proliferator-activated receptor-\u03b1\/\u03b3 agonist aleglitazar with placebo in patients with type 2 diabetes and recent ACS. In participants not treated with insulin, we determined whether baseline homeostasis model assessment of insulin resistance (HOMA-IR; n = 4303) or the change in HOMA-IR on assigned study treatment (n = 3568) was related to the risk of death or major adverse cardiovascular events (cardiovascular death, myocardial infarction, and stroke) in unadjusted and adjusted models. Because an inverse association of HOMA-IR with N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been described, we specifically examined effects of adjustment for the latter.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In unadjusted analysis, twofold higher baseline HOMA-IR was associated with lower risk of death [hazard ratio (HR): 0.79, 95% CI: 0.68 to 0.91, P = 0.002]. Adjustment for 24 standard demographic and clinical variables had minimal effect on this association. However, after further adjustment for NT-proBNP, the association of HOMA-IR with death was no longer present (adjusted HR: 0.99, 95% CI: 0.83 to 1.19, P = 0.94). Baseline HOMA-IR was not associated with major adverse cardiovascular events, nor was the change in HOMA-IR on study treatment associated with death or major adverse cardiovascular events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>After accounting for levels of NT-proBNP, insulin resistance assessed by HOMA-IR is not related to the risk of death or major adverse cardiovascular events in patients with type 2 diabetes and ACS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jc.2017-02772","type":"journal-article","created":{"date-parts":[[2018,4,6]],"date-time":"2018-04-06T21:50:06Z","timestamp":1523051406000},"page":"2522-2533","source":"Crossref","is-referenced-by-count":8,"title":["Homeostasis Model Assessment of Insulin Resistance and Survival in Patients With Diabetes and Acute Coronary Syndrome"],"prefix":"10.1210","volume":"103","author":[{"given":"Barbara E","family":"St\u00e4hli","sequence":"first","affiliation":[{"name":"Department of Cardiology, Charit\u00e9 Berlin \u2013 University Medicine, Campus Benjamin Franklin, Berlin, Germany"},{"name":"Montreal Heart Institute and Universit\u00e9 de Montr\u00e9al, Montreal, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Nozza","sequence":"additional","affiliation":[{"name":"Montreal Health Innovations Coordinating Center, Montreal QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilse C","family":"Schrieks","sequence":"additional","affiliation":[{"name":"Julius Clinical and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, CD Zeist, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John B","family":"Buse","sequence":"additional","affiliation":[{"name":"University of North Carolina School of Medicine, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klas","family":"Malmberg","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Stockholm, Sweden"},{"name":"Vicore Pharma, M\u00f6lndal, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Mellbin","sequence":"additional","affiliation":[{"name":"Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce","family":"Neal","sequence":"additional","affiliation":[{"name":"George Institute for Global Health and University of Sydney, Newtown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen J","family":"Nicholls","sequence":"additional","affiliation":[{"name":"South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Ryd\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anders","family":"Svensson","sequence":"additional","affiliation":[{"name":"F. 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