title: Growth hormone for risk stratification and effects of therapy in acute myocardial infarction.
abstract: BACKGROUND
  Excess growth hormone (GH) is associated with early mortality.
  
  
  OBJECTIVE
  We assessed the association of GH with prognosis after acute myocardial infarction (AMI), and the effects of secondary prevention therapies.
  
  
  METHODS
  GH was measured using a high-sensitivity assay in 953 AMI patients (687 males, mean age 66.1 ± 12.8 years).
  
  
  RESULTS
  During 2 years follow-up, there were 281 major adverse cardiac events (MACE). Patients with MACE had higher GH levels (median [range], 0.91 [0.04-26.28] μg/L) compared to event-free survivors (0.59 [0.02-21.6], p < 0.0005). In multivariate Cox survival analysis, GH was a significant predictor of MACE (hazard ratios 1.43, p = 0.026 and 1.49, p = 0.01, respectively) with significant interactions with beta blocker therapy (p = 0.047) and angiotensin converting enzyme inhibitor or angiotensin receptor blocker (ACE/ARB) therapy (p = 0.016).
  
  
  CONCLUSIONS
  GH levels post-AMI are prognostic for MACE and may indicate those patients who benefit from beta blocker and ACE/ARB therapy.
authors.affiliation: a Department of Cardiovascular Sciences , NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester , Leicester , UK .
authors.forename: Leong L
authors.initials: LL
authors.lastname: Ng
authors.affiliation: a Department of Cardiovascular Sciences , NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester , Leicester , UK .
authors.forename: Sanjay S
authors.initials: SS
authors.lastname: Bhandari
authors.affiliation: a Department of Cardiovascular Sciences , NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester , Leicester , UK .
authors.forename: Jatinderpal K
authors.initials: JK
authors.lastname: Sandhu
authors.affiliation: a Department of Cardiovascular Sciences , NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester , Leicester , UK .
authors.forename: Paulene A
authors.initials: PA
authors.lastname: Quinn
authors.affiliation: a Department of Cardiovascular Sciences , NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester , Leicester , UK .
authors.forename: Iain B
authors.initials: IB
authors.lastname: Squire
authors.affiliation: a Department of Cardiovascular Sciences , NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester , Leicester , UK .
authors.forename: Joan E
authors.initials: JE
authors.lastname: Davies
authors.affiliation: b Sphingotec GmbH , Hennigsdorf , Germany , and.
authors.forename: Joachim
authors.initials: J
authors.lastname: Struck
authors.affiliation: b Sphingotec GmbH , Hennigsdorf , Germany , and.
authors.forename: Andreas
authors.initials: A
authors.lastname: Bergmann
authors.affiliation: c Department of Cancer Studies and Molecular Medicine , Leicester Royal Infirmary, University of Leicester , Leicester , UK.
authors.forename: Donald J L
authors.initials: DJ
authors.lastname: Jones
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D013006:Growth Hormone / Q000097:blood*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy*; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D015415:Biomarkers; D013006:Growth Hormone
keywords: ACE inhibitors; beta blockers; growth hormone; myocardial infarction