Do growth hormone and insulin-like growth factor 1 affect prognosis in patients with killip I and II class acute myocardial infarction?

Abstract

We investigated concentrations and roles of insulin-like growth factor 1 (IGF-1) and its binding protein (IGF1BP-3), growth hormone (GH), insulin, and markers of insulin resistance and infl ammation in acute myocardial infarction (AMI). We aimed to assess any possible association between serum GH/IGF-1 axis following AMI and short-term survival rates. A follow up study was performed in 2010. Study group consisted of 75 patients with Killip I and II class AMI. Th ere were 30 control subjects. Blood samples were obtained within 24 hours of admission and analyzed for the aforementioned hormones. Patients were followed-up during 6 months for new cardiac events. Median GH was higher in AMI (0.96; range 0.6-2.4) than in controls (0.26; p < 0.001). IGF-1 was signifi cantly lower in AMI (123 vs. 132; p < 0.05), and so was the IGF-1/GH ratio (p < 0.001) and IGF1BP-3. Insulin was higher in study group, but without statistical signifi cance. However, we found signifi cant between-group diff erences in other markers of insulin resistance (HbA1c, glycemia, HOMA-IR) and infl ammation. Simple linear correlation showed positive correlation between GH and C-reactive protein. All patients with new cardiac events had IGF-1 below median and lower left ventricular ejection fraction. In conclusion, IGF-1 may aff ect outcome of AMI. GH resistance might be a result of infl ammatory/immune response and therefore it could be a useful prognostic marker.