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


METHODS
Community-based, prospective cohort study.


METHODS
Framingham, Massachusetts.


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


METHODS
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.
Vasan
Ramachandran S
RS
National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts 01702-5803, USA.
Sullivan
Lisa M
LM
D'Agostino
Ralph B
RB
Roubenoff
Ronenn
R
Harris
Tamara
T
Sawyer
Douglas B
DB
Levy
Daniel
D
Wilson
Peter W F
PW
D000368:Aged; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D020257:Ventricular Remodeling / Q000502:physiology
D007334:Insulin-Like Growth Factor I