title: Impact of age-adjusted insulin-like growth factor 1 on major cardiovascular events after acute myocardial infarction: results from the fast-MI registry.
abstract: BACKGROUND
  The GH/IGF-1 axis is being targeted for therapeutic development in diseases such as short stature, cancer, and metabolic disorders. The impact of IGF-1 in cardiovascular disease remains controversial. We therefore studied whether IGF-1 at admission for acute myocardial infarction (AMI) predicted death, recurrent AMI, and stroke over a 2-year follow-up.
  
  
  METHODS
  Using data from the French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction registry, we measured IGF-1 among all the 1005 patients with AMI who participated in the serum data bank. Because IGF-1 decreases with age, a standardized IGF-1 score was calculated as previously described [IGF-1 score = (log [IGF-1 (micrograms per liter)] + 0.00625 × age - 2.555)/0.104]. Impact of IGF-1 score (continuous and quartiles) on outcomes were compared using Cox proportional hazards regression models.
  
  
  RESULTS
  During follow-up, 190 patients died or had a recurrent AMI or stroke. Patients in the lowest quartile of IGF-1 were older and more frequently female and diabetic compared with patients in the other quartiles. After adjustment for known cardiovascular factors, an increase of five units of IGF-1 score was associated with a 30% decrease of the risk of events during follow-up (adjusted hazard ratio 0.70; 95% confidence interval 0.54-0.92; P = .0093). Similarly, the lowest quartile of IGF-1 was associated with an increased risk of events (adjusted hazard ratio 1.52, 95% confidence interval 1.11-2.08; compared with others quartiles, P = .010).
  
  
  CONCLUSIONS
  Low IGF-1 score is associated with an increased risk of all-cause death, recurrent myocardial infarction, and stroke in AMI patients. Whether patients treated by IGF-1 axis inhibitors have a specific clinical course after AMI would be worth studying.
authors.affiliation: Assistance Publique-Hôpitaux de Paris (O.B.), Department of Diabetology, Pitié Salpétrière Hospital, 75634 Paris, France; Sorbonne Universités (O.B., Y.L.B., T.S.), Université Paris Medical Center, Université Paris 06, and INSERM (O.B.), Unité Mixte de Recherche en Santé 1138, Centre de Recherche des Cordeliers, and INSERM (Y.L.B., N.B.), Unité Mixte de Recherche 938, Plateforme de Microdosages, 75006 Paris 06, France; Assistance Publique-Hôpitaux de Paris (Y.L.B.), Trousseau Hospital, 75571 Paris, France; Centre Hospitalier St Joseph-St Luc (B.R.), 69372 Lyon, France; Hôpital Arnaud de Villeneuve (F.L.), 34295 Montpellier, France; Centre Hospitalier Jacques Coeur (X.T.), 18000 Bourges, France; Assistance Publique-Hôpitaux de Paris (L.B., S.K., E.D., T.S.), URCEST, St Antoine Hospital, 75571 Paris, France; Société Française de Cardiologie (G.M.), 75012 Paris, France; Assistance Publique-Hôpitaux de Paris (N.D.), Hôpital Européen Georges Pompidou, Department of Cardiology, 75475 Paris, France; and Université René-Descartes (N.D.), 75014 Paris 05, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bourron
authors.forename: Yves
authors.initials: Y
authors.lastname: Le Bouc
authors.forename: Laurence
authors.initials: L
authors.lastname: Berard
authors.forename: Salma
authors.initials: S
authors.lastname: Kotti
authors.forename: Nadège
authors.initials: N
authors.lastname: Brunel
authors.forename: Bernard
authors.initials: B
authors.lastname: Ritz
authors.forename: Florence
authors.initials: F
authors.lastname: Leclercq
authors.forename: Xavier
authors.initials: X
authors.lastname: Tabone
authors.forename: Elodie
authors.initials: E
authors.lastname: Drouet
authors.forename: Geneviève
authors.initials: G
authors.lastname: Mulak
authors.forename: Nicolas
authors.initials: N
authors.lastname: Danchin
authors.forename: Tabassome
authors.initials: T
authors.lastname: Simon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D011379:Prognosis; D012042:Registries
chemical_list: D007334:Insulin-Like Growth Factor I