{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:00:39Z","timestamp":1785128439528,"version":"3.55.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82470387"],"award-info":[{"award-number":["82470387"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82000368"],"award-info":[{"award-number":["82000368"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81970327"],"award-info":[{"award-number":["81970327"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82270383"],"award-info":[{"award-number":["82270383"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Insulin resistance may influence myocardial recovery after ischemic injury, but its relevance to post-revascularization remodeling and long-term outcomes remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We examined 732 patients with ischemic cardiomyopathy who underwent revascularization and had complete metabolic and echocardiographic data, with a median follow-up of 8.1 years. Insulin sensitivity was assessed using the Quantitative Insulin Sensitivity Check Index (QUICKI). Ventricular remodeling was evaluated by changes in LVEDD and LVESD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across penalized regression and complementary machine-learning analyses, QUICKI consistently showed a stronger association with cardiovascular mortality than fasting glucose, insulin, or lipid measures. Lower QUICKI values were linked to greater ventricular dilatation, and these associations remained stable across analytic frameworks. Time-dependent ROC analysis demonstrated that QUICKI provided high early discriminatory performance for cardiovascular death. External validation in NHANES 2013-2016 further supported an inverse relationship between QUICKI and cardiovascular mortality risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These findings suggest that insulin sensitivity, captured by a simple fasting-based index, reflects a metabolic vulnerability that relates to both structural remodeling and long-term prognosis after revascularization, aligning with the metabolic dimension of the CKM framework and offering a potential addition to contemporary risk-stratification strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1796332","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T04:25:33Z","timestamp":1785126333000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Insulin sensitivity and cardiovascular risk after revascularization: associations with remodeling and long-term outcomes"],"prefix":"10.3389","volume":"13","author":[{"given":"Ruixuan","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Xi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Zong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roubai","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suyi","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1505","DOI":"10.1007\/s11886-022-01766-6","article-title":"Ischemic cardiomyopathy and heart failure after acute myocardial infarction","volume":"24","author":"Del Buono","year":"2022","journal-title":"Curr Cardiol Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"482","DOI":"10.3389\/fphys.2014.00482","article-title":"Passive ventricular remodeling in cardiac disease: focus on heterogeneity","volume":"5","author":"Kessler","year":"2014","journal-title":"Front Physiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1002\/ejhf.2493","article-title":"Cardiac remodelling\u2014part 1: from cells and tissues to circulating biomarkers. 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