Plasma insulin-like growth factor I as predictor of progression and all cause mortality in chronic heart failure

ObjectivesInsulin-like growth factor I (IGF-I) is an anabolic growth factor that seems to increase cardiac contractility. Reduced levels of IGF-I may be implicated in progression of CHF. The objective was to compare plasma IGF-I in CHF patients with healthy controls, and to examine the associations between baseline IGF-I levels, cardiac contractility and the prognosis as judged by all cause mortality and progression of CHF requiring admission to hospital.MethodsA prospective study comprising 194 CHF outpatients, and 169 matched controls. All patients and controls underwent echocardiographic examination at baseline. Patients were followed for a median of 30 months.ResultsThere was no difference in IGF-I levels between patients and controls (median and interquartile range), 78 (58–91) vs. 77 (57–94) ng/mL (P = 0.92). Age-adjusted IGF-I levels were not related to left ventricular ejection fraction (LVEF) (P = 0.58) or levels of N-terminal B-Type natriuretic peptide (NT-proBNP) (P = 0.42).During follow-up 44 patients died and 94 were admitted to hospital due to worsening of CHF. Adjusted for cardiovascular risk factors (age, gender, NT-proBNP, lipids, diabetes mellitus, blood pressure, renal function and LVEF) IGF-I levels did not influence the overall mortality risk or the admission rate to hospital, hazard ratio (HR) (95% confidence intervals) 1.05 (0.75–1.47) (P = 0.77) and 1.00 (0.80–1.26) (P = 0.96), respectively per each SD increase in log IGF-I levels.ConclusionsIGF-I levels were not reduced in patients with CHF and did not influence cardiac status at baseline or the prognosis.