Key result
Higher serum IGF-1 levels independently predicted a lower risk of cardiovascular mortality (HR 0.42) in patients with heart failure with reduced ejection fraction.
Why the study?
Heart failure involves multiple hormonal alterations and frequent renal failure, but the relationship between renal function, IGF-1 deficiency, and cardiovascular mortality was unclear.
Observational (n=337)
Yes
Hazard Ratio: 0.42 (95% CI 0.23–0.77)
p-value: p=0.005
Lower serum IGF-1 levels independently predict cardiovascular mortality in patients with HFrEF, particularly in younger and high-risk patients.
Supports IGF-1 as prognostic marker in HFrEF; hypothesis-generating and should not yet change practice.
INTRODUCTION: Data from the "Trattamento Ormonale nello Scompenso CArdiaco" (T.O.S.CA) registry showed that heart failure (HF) represents a complex clinical syndrome with different hormonal alterations. Renal failure represents a frequent complication in HF. We evaluated the relationship between renal function and insuline-like growth factor-1 (IGF-1) deficiency and its impact on cardiovascular mortality (CVM) in patients enrolled in the T.O.S.CA. registry. METHODS: At the enrolment, all subjects underwent chemistry examinations, including circulating hormones and cardiovascular functional tests. COX regression analysis was used to evaluate factors related to CVM during the follow-up period in all populations, in high-risk patients and in the young-adult population. Also, we evaluate the effects of renal function on the CVM. RESULTS: 337 patients (41 deceased) were analyzed. CVM was related to severe renal dysfunction (HR stages IV-V = 4.86), high-risk conditions (HR 2.25), serum IGF-1 (HR 0.42), and HF etiology (HR 5.85 and HR 1.63 for valvular and ischemic etiology, respectively). In high-risk patients, CVM was related to IGF-1 levels, severe renal dysfunction and valvular etiology, whereas in young patients CMV was related to the high-risk pattern and serum IGF-1 levels. CONCLUSIONS: Our study showed the clinical and prognostic utility of the IGF-1 assay in patients with HF.
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Giorgi et al. (2022) conducted an observational in Heart failure with reduced ejection fraction (HFrEF) (n=337). Serum IGF-1 levels vs. Lower serum IGF-1 levels was evaluated on Cardiovascular mortality (HR 0.42, 95% CI 0.23-0.77, p=0.005). Higher serum IGF-1 levels independently predicted a lower risk of cardiovascular mortality (HR 0.42) in patients with heart failure with reduced ejection fraction.
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