Serum insulin-like growth factor I and risk for heart failure in elderly individuals without a previous myocardial infarction: the Framingham Heart Study.

Vasan RS, Sullivan LM, D'Agostino RB, Roubenoff R, Harris T, Sawyer DB, Levy D, Wilson PW
Ann Intern Med. 2003 139 (8): 642-8

PMID: 14568852 · DOI:10.7326/0003-4819-139-8-200310210-00007

BACKGROUND - Several experimental investigations have emphasized the favorable effects of insulin-like growth factor I (IGF-I) on left ventricular remodeling, partly through its antiapoptotic effects. Cross-sectional clinical studies have reported that low serum IGF-I levels in patients with heart failure correlate with cachexia and severity of ventricular dysfunction. It is unclear whether low serum IGF-I is a risk factor for heart failure.

OBJECTIVE - To prospectively study the association between serum IGF-I level and the incidence of congestive heart failure.

DESIGN - Community-based, prospective cohort study.

SETTING - Framingham, Massachusetts.

PARTICIPANTS - 717 elderly individuals (mean age, 78.4 years; 67% women) who did not have myocardial infarction and congestive heart failure at baseline.

MEASUREMENT - Incidence of a first episode of congestive heart failure on follow-up.

RESULTS - During follow-up (mean, 5.2 years), 56 participants (35 women) developed congestive heart failure. In multivariable Cox regression models adjusting for established risk factors at baseline, there was a 27% decrease in risk for heart failure for every 1 standard deviation increment in log IGF-I. Individuals with serum IGF-I level at or above the median value (140 microg/L) had half the risk for heart failure (hazard ratio, 0.49 [95% CI, 0.26 to 0.92]) of those with serum IGF-I levels below the median. These comparisons were maintained in analyses adjusting for the occurrence of a myocardial infarction on follow-up.

CONCLUSIONS - In our prospective, community-based investigation, serum IGF-I level was inversely related to the risk for congestive heart failure in elderly people without a previous myocardial infarction. Additional investigations are warranted to confirm these findings.

MeSH Terms (11)

Aged Female Heart Failure Humans Incidence Insulin-Like Growth Factor I Male Proportional Hazards Models Prospective Studies Risk Factors Ventricular Remodeling

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