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Serum Insulin-like Growth Factor I and Risk for Heart Failure in Elderly Individuals without a Previous Myocardial Infarction: The Framingham Heart Study

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; and Peter W.F. Wilson, MD
[+] Article and Author Information

From the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts; Boston University and Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts; and National Institute on Aging and National Heart, Lung, and Blood Institute, Bethesda, Maryland.


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.


Ann Intern Med. 2003;139(8):642-648. doi:10.7326/0003-4819-139-8-200310210-00007
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Several basic science reports have emphasized a fundamental role of IGF-I in regulating myocardial structure and function through its beneficial effects on cardiac myocyte survival, growth, calcium signaling, and differentiation (12, 27). Overexpression of IGF-I has a salutary effect in experimental models of heart failure (2831). In clinical studies of patients with heart failure, IGF-I levels are low and correlate with the severity of ventricular systolic dysfunction and the degree of cachexia (89). These experimental and clinical data suggest that IGF-I may be cardioprotective even in individuals without heart failure or clinically apparent myocardial injury. However, the contribution of serum IGF-I levels to risk for heart failure in the general population is unknown. The present investigation examined, for the first time, the association between serum IGF-I levels and risk for congestive heart failure in elderly individuals who did not have a previous myocardial infarction.

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Figure.
Age- and sex-adjusted probability of developing congestive heart failure in participants according to serum insulin-like growth factor I (IGF-I) level at or above the median (140 µg/L).dotted linesolid line

Adjusted probabilities are estimated by Cox proportional-hazards regression with age and sex as covariates. The curves represent probabilities for typical participants (by sex and age) in the 2 serum IGF-I groups: participants with congestive heart failure and participants at risk with serum IGF-I level at or above the median ( ), 19 and 356 participants (5.3%), respectively, and participants with congestive heart failure and participants at risk with serum IGF-I level below the median ( ), 37 and 361 participants (10.2%), respectively. The numbers of participants with congestive heart failure and participants still at risk at each year of follow-up are presented below the figure. Data are shown only through 6 years of follow-up.

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Summary for Patients

Insulin-like Growth Factor I Levels and Heart Failure Risk in Older People

The summary below is from the full report titled “Serum Insulin-like Growth Factor I and Risk for Heart Failure in Elderly Individuals without a Previous Myocardial Infarction: The Framingham Heart Study.” It is in the 21 October 2003 issue of Annals of Internal Medicine (volume 139, pages 642-648). The authors are R.S. Vasan, L.M. Sullivan, R.B. D'Agostino, R. Roubenoff, T. Harris, D.B. Sawyer, D. Levy, and P.W.F. Wilson.

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