High levels of the anti-inflammatory LXA4 appear to protect against ischemic complications after AMI, but this benefit weakens in the presence of DM or insulin resistance (IR). A prospective study published in Diabetology & Metabolic Syndrome examined how metabolic status modifies the prognostic value of LXA4 in AMI.

Between March 2017 and January 2020, 1,569 patients were enrolled, and plasma LXA4 levels were measured using enzyme-linked immunosorbent assay. Participants were grouped by DM status and TyG index. In non-diabetic patients with low TyG, higher LXA4 levels were associated with a 58% lower risk of MACE (HR: 0.42; 95% CI: 0.28–0.65; P < 0.001), primarily due to fewer recurrent myocardial infarctions and revascularizations. No significant benefit was seen in those with diabetes or higher TyG levels (P interaction = 0.044).

These findings suggest that diabetes and insulin resistance may blunt the cardioprotective and anti-inflammatory effects of LXA4 following AMI. Identifying metabolic factors that influence inflammation resolution could improve post-infarction risk assessment.