Single-point insulin sensitivity estimator and left main and/or three-vessel disease in patients aged 45 years or older with acute coronary syndrome: findings from the CCC-ACS project - Report - MDSpire

Single-point insulin sensitivity estimator and left main and/or three-vessel disease in patients aged 45 years or older with acute coronary syndrome: findings from the CCC-ACS project

  • By

  • Mengchen Li

  • Yuyang Sun

  • Yu Liu

  • Yan Sun

  • Dai Zhang

  • Yujing Cheng

  • Xiaoli Liu

  • July 9, 2026

  • 0 min

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Clinical Report: Association of SPISE with Severe Coronary Disease in ACS Patients

Overview

This study investigates the relationship between the single-point insulin sensitivity estimator (SPISE) and severe coronary anatomical involvement in patients aged 45 and older experiencing acute coronary syndrome (ACS).

Background

Acute coronary syndrome (ACS) is a significant contributor to morbidity and mortality globally, with severe coronary anatomical involvement indicating a higher ischemic burden and poorer clinical outcomes. Insulin resistance (IR) is linked to the progression of atherosclerotic cardiovascular disease, and identifying reliable markers of IR could enhance risk stratification in ACS patients. The SPISE offers a non-invasive method to evaluate insulin sensitivity.

Data Highlights

OutcomeOdds Ratio (OR)95% Confidence Interval (CI)
Left main and/or three-vessel disease0.9770.957–0.998
Isolated three-vessel disease0.9570.935–0.980

Key Findings

  • Higher SPISE is associated with lower odds of severe coronary anatomical outcomes.
  • Each 1-unit increase in SPISE correlates with reduced odds of left main and/or three-vessel disease.
  • Patients in the highest SPISE tertile have lower odds of severe coronary disease compared to those in the lowest tertile.
  • Age-related heterogeneity was observed, with stronger associations in patients aged <65 years.
  • Restricted cubic spline analyses indicated dose-response relationships between SPISE and coronary disease severity.

Clinical Implications

The findings indicate a relationship between SPISE and severe coronary anatomical involvement in ACS.

Conclusion

Higher SPISE values are linked to lower odds of severe coronary disease in ACS patients aged 45 and older, particularly in those younger than 65.

Related Resources & Content

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  4. ACC, AHA Issue New Acute Coronary Syndromes Guideline - American College of Cardiology
  5. European Radiology — Detection of Silent Myocardial Infarction Fatty Scars via Coronary Calcium Scoring CT in Diabetic Individuals Lacking Coronary Heart Disease History
  6. ACC, AHA Issue New Acute Coronary Syndromes Guideline - American College of Cardiology
  7. Purpose in Life and Insulin Resistance in a Large Occupational Cohort: Cross-Sectional Associations Using TyG, SPISE-IR, and METS-IR Indices | MDPI
  8. Association of the Triglyceride–Glucose Index with Major Adverse Cardiovascular Events in Patients with Acute Coronary Syndromes: A Systematic Review and Meta-Analysis - PMC

Original Source(s)

Single-point insulin sensitivity estimator and left main and/or three-vessel disease in patients aged 45 years or older with acute coronary syndrome: findings from the CCC-ACS project

  • by Mengchen Li, Yuyang Sun, Yu Liu, Yan Sun, Dai Zhang, Yujing Cheng, Xiaoli Liu

  • July 9, 2026

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