SIGNIFICANCE OF ADMISSION INSULIN RESISTANCE INDEX IN NON-DIABETIC PATIENTS WITH ACUTE CORONARY SYNDROMES

Insulin resistance and its associated with metabolic abnormalities predisposing to cardiovascular diseases have become a focus of intensive investigation. The importance of insulin resistance is obvious since high fasting or post glucose load insulin level as well as insulin per se have been shown to be a risk factor for coronary heart disease (CHD).Insulin resistance is a multisystem disorder that is associated with multiple metabolic and cellular alteration including atherogenic dys-lipidemia, glucose intolerance, hypertension and prothrombotic state.Insulin resistance is a fundamental abnormality in the pathogenesis of type 2 DM and may play a role in the development of atherosclerotic cardiovascular diseases , it may be an expression of diffuse arterial endothelial dysfunction contributing to atherosclerosis, may lead directly to arterial damage through toxic effect of hyperinsulinemia or indirectly through atherogenic effects associated with the insulin resistance syndrome.Atherogenic dyslipidemia is characterized by three lipoprotein abnormalities elevated VLDL, small LDL particles and decreased HDL cholesterol level (the lipid triad). Hypertension is well established risk factor for macrovascular events and is associated with insulin resistance, the prothrombotic status more recently recognized component of the metabolic syndrome, people with the metabolic syndrome exhibit a pattern of coagulation factors that promote thrombosis or