title: The role of insulin-like growth factor-1 in development of coronary no-reflow and severity of coronary artery disease in patients with acute myocardial infarction.
abstract: BACKGROUND
  Insulin-like growth factor-1 (IGF-1) has atheroprotective effects via reduction in oxidative stress, cellular apoptosis, pro-inflammatory signaling, and endothelial dysfunction.
  
  
  OBJECTIVE
  We hypothesized that low levels of IGF-1 may be associated with the severity and extent of coronary artery disease and development of the coronary no-reflow phenomenon in patients with acute ST-elevation myocardial infarction (STEMI) and investigated the role of the IGF-1 molecule in the coronary no-reflow phenomenon and severity of coronary artery disease (CAD) in patients with acute STEMI in a tertiary hospital.
  
  
  METHODS
  The study was conducted among 113 patients undergoing primary percutaneous coronary intervention (PPCI) for STEMI, of whom 49 patients developed the no-reflow phenomenon. Coronary no-reflow was defined as Thrombolysis In Myocardial Infarction (TIMI) flow grade 2 or less after intervention. Insulin-like growth factor-1 levels were measured in both groups. The severity and extent of CAD were evaluated according to the Gensini and Syntax scores.
  
  
  RESULTS
  Although IGF-1 levels were lower in the no-reflow group, there was not a statistically significant difference between the no-reflow group and the control group (116.65 ±51.72 vs. 130.82 ±48.76, p = 0.130). Gensini and Syntax scores were higher in the no-reflow group. There was no association between Gensini and Syntax scores and IGF-1 levels (r = -0.071, r = 0.479, r = -0.158, p = 0.113).
  
  
  CONCLUSIONS
  In this study, IGF-1 levels were not statistically different between patients developing the no-reflow phenomenon and controls. There was no association between development of the no-reflow phenomenon and severity of CAD or IGF-1 levels. Nevertheless, large scale studies are needed to verify these results.
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Halkali, Istanbul, Turkey.
authors.forename: Ibrahim Faruk
authors.initials: IF
authors.lastname: Akturk
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Halkali, Istanbul, Turkey.
authors.forename: Ahmet Arif
authors.initials: AA
authors.lastname: Yalcin
authors.affiliation: Department of Cardiology, Usak State Hospital, Usak, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Biyik
authors.affiliation: Department of Cardiology, Istanbul Education and Research Hospital, Istanbul, Turkey.
authors.forename: Nihan Turhan
authors.initials: NT
authors.lastname: Caglar
authors.affiliation: Department of Biochemistry, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Halkali, Istanbul, Turkey.
authors.forename: Nilgun
authors.initials: N
authors.lastname: Isiksacan
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Halkali, Istanbul, Turkey.
authors.forename: Cetin
authors.initials: C
authors.lastname: Sarikamis
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Halkali, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Uzun
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Halkali, Istanbul, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Celik
authors.affiliation: Department of Cardiology, Bakirkoy Dr Sadi Konuk Education and Research Hospital, Bakirkoy, Istanbul, Turkey.
authors.forename: Ilker Murat
authors.initials: IM
authors.lastname: Caglar
keywords: ST-elevation myocardial infarction; coronary artery disease; insulin-like growth factor-1; no-reflow