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首页> 外文期刊>The American Journal of Cardiology >Insulin Resistance Modifies the Effects of Omega-3 Acid Ethyl Esters on Left Ventricular Remodeling After Acute Myocardial Infarction (from the OMEGA-REMODEL Randomized Clinical Trial)
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Insulin Resistance Modifies the Effects of Omega-3 Acid Ethyl Esters on Left Ventricular Remodeling After Acute Myocardial Infarction (from the OMEGA-REMODEL Randomized Clinical Trial)

机译：胰岛素抗性改变ω-3酸乙酯对急性心肌梗死后左心室重塑的影响（来自Omega-Remodel随机临床试验）

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Insulin resistance early after acute myocardial infarction is associated with increased heart failure and mortality. OMEGA -REMODEL was a prospective double-blind 1:1 randomized control trial of patients with AMI. We reported that 6-month treatment with omega-3 fatty acid (O-3FA) 4 g/day attenuated cardiac remodeling accompanied by reduction in inflammation. We hypothesized that insulin resistance modifies the therapeutic effect of O-3FA on post-MI cardiac remodeling. The OMEGA-REMODEL study group was dichotomized according to cohort- and gender-specific median cutoff value of leptin-to-adiponectin ratio (LAR) at baseline (LAR-Hi vs LAR-Lo). Mixed model regression analyses were used to evaluate effect modification of O-3FA on reduction of left ventricular end-systolic volume index (LVESVI) by LAR status. Baseline LAR was evaluated on 325 patients (59 11 years, 81% male). A total of 168 patients were categorized in LARLo, and 157 in LAR-Hi. O-3FA treatment resulted in significant LVESVI reduction in patients with LAR-Lo but not with LAR-Hi (p = 0.0002 vs 0.66, respectively). Mixed model regression analysis showed significant modification of LAR on O-3FA's treatment effect in attenuating LVESVI (p = 0.021). In conclusion, this post-hoc efficacy analysis suggests that LAR status significantly modified O-3FA's treatment effect in attenuating cardiac remodeling. During the convalescent phase of acute infarct healing, patients with lower insulin resistance estimated by LAR appear to derive more therapeutic response from O-3FA toward improvement of LVESVI. (C) 2019 Elsevier Inc. All rights reserved.
机译：急性心肌梗死早期的胰岛素抵抗与心力衰竭和死亡率增加有关。 Omega -Remodel是一款前瞻性双盲1：1 AMI患者随机对照试验。我们报道，用ω-3脂肪酸（O-3FA）4克/天的6个月治疗伴有炎症的减少伴随着炎症的心脏重塑。我们假设胰岛素抗性改变O-3FA对MI后心脏重塑的治疗作用。 ω-Remodel研究组根据基线（Lar-Hi Vs LaR-Lo）的瘦蛋白 - 脂联素比（LAR）的核心和性别特异性中值截止值（LAR）。混合模型回归分析用于评估O-3FA对左心室收缩体积指数（LVESVI）减少的影响改性。在325名患者（591岁，81％的男性）评估基线Lar。总共168名患者分类为Larlo，157名患者在Lar-Hi中分类。 O-3FA处理导致LAR-LO患者的显着降低，但不具有LAR-HI（P = 0.0002 Vs 0.66）。混合模型回归分析表明，在衰减叶韦（P = 0.021）中对O-3FA治疗效果的显着修饰（P = 0.021）。总之，这种后期后疗效分析表明，LAR状态明显修正了O-3FA的治疗效果，在减少心脏重塑方面。在急性梗死愈合的临时阶段，胰岛素抵抗较低的患者估计估计来自O-3FA的更高治疗反应，从O-3FA改善叶片。 （c）2019 Elsevier Inc.保留所有权利。

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