title: Effects of insulin-like growth factor 1 in preventing acute coronary syndromes: the PRIME study.
abstract: OBJECTIVE
  Insulin-like growth factor-1 (IGF-1) has been associated with cardiovascular risk factors and atherosclerosis. The aim of the present study was to evaluate the prognostic value of IGF-1 concentrations with respect to occurrence of well-defined coronary syndromes.
  
  
  METHODS
  The PRIME study is a prospective cohort having included 10,600 subjects from Northern Ireland and France. Detailed information on cardiovascular risk factors, socioeconomic and behavioural variables were collected and a cardiologic examination was performed. At 5-year follow-up, 317 incident cases of coronary events were recorded according to strict protocols. They were matched to 634 age- and centre-paired controls from the same cohort, free of coronary disease. Baseline IGF-1 concentrations were measured, together with variables of lipid and glucose metabolism and markers of vascular and systemic inflammation.
  
  
  RESULTS
  Baseline IGF-1 concentration was lower in subjects developing an acute coronary syndrome than in unaffected controls. IGF-1 levels correlated negatively with age, waist circumference, tobacco consumption and markers of inflammation. Subjects in the highest quartile of IGF-1 distribution had a 55% reduction in the relative risk of developing myocardial infarction and a 45% decrease for all-combined acute coronary syndromes. A similar trend, although non-significant, was noted for angina pectoris. Multiple adjustments on classical risk factors and inflammation markers did not affect IGF-1 results. Elevated levels of both IGF-1 and apo A-I conferred a significantly greater risk reduction than either one alone. However, interaction between the two markers was not significant.
  
  
  CONCLUSIONS
  Like HDL markers, high levels of IGF-1 confer protection against coronary artery disease.
authors.affiliation: Department of Epidemiology, Toulouse University School of Medicine, Toulouse, France. jean-bernard.ruidavets@cict.fr
authors.forename: J B
authors.initials: JB
authors.lastname: Ruidavets
authors.forename: G
authors.initials: G
authors.lastname: Luc
authors.forename: E
authors.initials: E
authors.lastname: Machez
authors.forename: A L
authors.initials: AL
authors.lastname: Genoux
authors.forename: F
authors.initials: F
authors.lastname: Kee
authors.forename: D
authors.initials: D
authors.lastname: Arveiler
authors.forename: P
authors.initials: P
authors.lastname: Morange
authors.forename: J V
authors.initials: JV
authors.lastname: Woodside
authors.forename: P
authors.initials: P
authors.lastname: Amouyel
authors.forename: A
authors.initials: A
authors.lastname: Evans
authors.forename: P
authors.initials: P
authors.lastname: Ducimetière
authors.forename: A
authors.initials: A
authors.lastname: Bingham
authors.forename: J
authors.initials: J
authors.lastname: Ferrières
authors.forename: B
authors.initials: B
authors.lastname: Perret
mesh_terms: D054058:Acute Coronary Syndrome / Q000235:genetics* / Q000517:prevention & control*; D050197:Atherosclerosis / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000378:metabolism; D016022:Case-Control Studies; D015331:Cohort Studies; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D007249:Inflammation; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000378:metabolism; D009660:Northern Ireland; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D007334:Insulin-Like Growth Factor I