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Growth hormone for risk stratification and effects of therapy in acute myocardial infarction
Leong L Ng1, Sanjay S Bhandari1, Jatinderpal K Sandhu1
1a Department of Cardiovascular Sciences , NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester , Leicester , UK .
Context:
Excess growth hormone (GH) is associated with early mortality.
Objectives:
We assessed the association of GH with prognosis after acute myocardial infarction (AMI), and the effects of secondary prevention therapies.
Methods:
GH was measured using a high-sensitivity assay in 953 AMI patients (687 males, mean age 66.1 ± 12.8 years).
Results:
During 2 years follow-up, there were 281 major adverse cardiac events (MACE). Patients with MACE had higher GH levels (median [range], 0.91 [0.04-26.28] microg/L) compared to event-free survivors (0.59 [0.02-21.6], p < 0.0005). In multivariate Cox survival analysis, GH was a significant predictor of MACE (hazard ratios 1.43, p = 0.026 and 1.49, p = 0.01, respectively) with significant interactions with beta blocker therapy (p = 0.047) and angiotensin converting enzyme inhibitor or angiotensin receptor blocker (ACE/ARB) therapy (p = 0.016).
Conclusions:
GH levels post-AMI are prognostic for MACE and may indicate those patients who benefit from beta blocker and ACE/ARB therapy.
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