TY - JOUR
T1 - Serum Insulin-like Growth Factor I and Risk for Heart Failure in Elderly Individuals without a Previous Myocardial Infarction
T2 - The Framingham Heart Study
AU - Vasan, Ramachandran S.
AU - Sullivan, Lisa M.
AU - D'Agostino, Ralph B.
AU - Roubenoff, Ronenn
AU - Harris, Tamara
AU - Sawyer, Douglas B.
AU - Levy, Daniel
AU - Wilson, Peter W.F.
PY - 2003/10/21
Y1 - 2003/10/21
N2 - 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. Design: Community-based, prospective cohort study. Setting: Framingham, Massachusetts. Participants: 717 elderly individuals (mean age, 78.4 years; 67% women) who did not have myocardial infarction and congestive heart failure at baseline. Measurement: 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 μg/L) had half the risk for heart failure (hazard ratio, 0.49 [95% Cl, 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.
AB - 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. Design: Community-based, prospective cohort study. Setting: Framingham, Massachusetts. Participants: 717 elderly individuals (mean age, 78.4 years; 67% women) who did not have myocardial infarction and congestive heart failure at baseline. Measurement: 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 μg/L) had half the risk for heart failure (hazard ratio, 0.49 [95% Cl, 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.
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U2 - 10.7326/0003-4819-139-8-200310210-00007
DO - 10.7326/0003-4819-139-8-200310210-00007
M3 - Article
C2 - 14568852
AN - SCOPUS:0142056143
SN - 0003-4819
VL - 139
SP - 642-648+I22
JO - Annals of internal medicine
JF - Annals of internal medicine
IS - 8
ER -