Metabolic disturbances after acute vascular events: A comparative study of acute coronary syndrome and ischaemic atherothrombotic stroke

Objective This pilot study aimed to compare metabolic disturbances, particularly insulin resistance (IR) and cardiovascular risk factors (CRFs), following two types of acute vascular atherothrombotic disease events: ischaemic atherothrombotic stroke (AS); and acute coronary syndrome (ACS). Design and methods A total of 110 non-diabetic patients presenting with either AS ( n =55) or ACS ( n =55) were included in our prospective comparative study, and matched for age and gender. IR was determined using the homoeostasis model assessment of insulin resistance (HOMA-IR) method, and each patient's personal and family history were also recorded. Results IR was significantly higher in the ACS vs AS group (HOMA-IR index 2.17±1.90 vs 1.50±0.81, respectively; P =0.03). The AS group had a significantly higher prevalence of personal history of hypertension (51% vs 31%; P =0.03), while current smoking was more prevalent in the ACS group (30% vs 18%; P =0.04). There were no significant differences between the two groups as regards any other CRFs. Conclusion The distribution of CRFs varied depending on the vascular event, and metabolic disturbances differed according to the atherothrombotic disease. IR was greater after ACS than AS.