Ramachandran S. Vasan, MD; Lisa M. Sullivan, PhD; Ralph B. D'Agostino, PhD; Ronenn Roubenoff, MD, MHS; Tamara Harris, MD, MS; Douglas B. Sawyer, MD, PhD; Daniel Levy, MD; Peter W.F. Wilson, MD
Grant Support: In part by National Institutes of Health (NIH) and National Heart, Lung, and Blood Institute (NHLBI) contract N01-HC-25195, NHLBI grant 1K24 HL04334 (Dr. Vasan), NIH and U.S. Department of Agriculture interagency agreement Y01-AG-4-0245 (Dr. Roubenoff), and NIH grants DK02120 (Dr. Roubenoff) and AG15797 (Dr. Roubenoff).
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Ramachandran S. Vasan, MD, The Framingham Heart Study, 73 Mount Wayte Avenue, Suite 2, Framingham, MA 01702-5803.
Current Author Addresses: Drs. Vasan and Levy: 73 Mount Wayte Avenue, Suite 2, Framingham, MA 01702-5803.
Drs. Sullivan and D'Agostino: 111 Cummington Street, Boston, MA 02215.
Dr. Roubenoff: 75 Sidney Street, Cambridge, MA 02134.
Dr. Harris: 7201 Wisconsin Avenue, Bethesda, MD 20892-9205.
Drs. Sawyer and Wilson: 715 Albany Street, Boston, MA 02118.
Author Contributions: Conception and design: R.S. Vasan, R.B. D'Agostino, R. Roubenoff, D. Levy.
Analysis and interpretation of the data: R.S. Vasan, L.M. Sullivan, R.B. D'Agostino, D.B. Sawyer, D. Levy, P.W.F. Wilson.
Drafting of the article: R.S. Vasan, L.M. Sullivan, D.B. Sawyer, D. Levy.
Critical revision of the article for important intellectual content: R.S. Vasan, L.M. Sullivan, R.B. D'Agostino, D.B. Sawyer, D. Levy, P.W.F. Wilson.
Final approval of the article: R.S. Vasan, L.M. Sullivan, R.B. D'Agostino, T. Harris, D. Levy, P.W.F. Wilson.
Provision of study materials or patients: R. Roubenoff, T. Harris.
Statistical expertise: L.M. Sullivan.
Obtaining of funding: R. Roubenoff, T. Harris.
Administrative, technical, or logistic support: T. Harris, D. Levy, P.W.F. Wilson.
Collection and assembly of data: T. Harris.
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.
To prospectively study the association between serum IGF-I level and the incidence of congestive heart failure.
Community-based, prospective cohort study.
717 elderly individuals (mean age, 78.4 years; 67% women) who did not have myocardial infarction and congestive heart failure at baseline.
Incidence of a first episode of congestive heart failure on follow-up.
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 g/L) had half the risk for heart failure (hazard ratio, 0.49 [95% CI, 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.
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.
Ramachandran S. Vasan, Lisa M. Sullivan, Ralph B. D'Agostino, Ronenn Roubenoff, Tamara Harris, Douglas B. Sawyer, et al. Serum Insulin-like Growth Factor I and Risk for Heart Failure in Elderly Individuals without a Previous Myocardial Infarction: The Framingham Heart Study. Ann Intern Med. 2003;139:642–648. doi: 10.7326/0003-4819-139-8-200310210-00007
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Published: Ann Intern Med. 2003;139(8):642-648.
Acute Coronary Syndromes, Cardiology, Coronary Heart Disease, Emergency Medicine, Geriatric Medicine.
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