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.
Vasan RS, Sullivan LM, D'Agostino RB, Roubenoff R, Harris T, Sawyer DB, 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. ;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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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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