IGF-1 is not related to long-term outcome in hyperglycemic acute coronary syndrome patients

Area of Science:

• Cardiology
• Endocrinology
• Metabolic Syndrome

Background:

• Insulin-like growth factor-1 (IGF-1) has a complex role in ischemic heart disease.
• The prognostic value of IGF-1 in acute coronary syndrome (ACS) patients, particularly those with hyperglycemia, is not well-defined.
• Understanding IGF-1's impact on cardiovascular events and related complications is crucial for patient management.

Purpose of the Study:

• To investigate the association between admission IGF-1 levels and major adverse cardiovascular events (MACE) over 5 years in hyperglycemic ACS patients.
• To determine if IGF-1 levels predict type 2 diabetes diagnosis at discharge.
• To assess the relationship between IGF-1 levels and post-ACS myocardial infarct size and left ventricular dysfunction.

Main Methods:

• A post hoc analysis of the BIOMArCS-2 randomized controlled trial involving 276 hyperglycemic ACS patients (glucose 140–288 mg/dL).
• IGF-1 levels were measured from admission blood samples.
• Major adverse cardiovascular events (MACE) were tracked for 5 years; type 2 diabetes was diagnosed via oral glucose tolerance test; myocardial infarct size and function were assessed using myocardial perfusion scintigraphy (MPS).

Main Results:

• The cumulative incidence of MACE at 5 years was 24%.
• IGF-1 was not independently associated with MACE (HR: 1.00, p=0.29).
• The highest quartile of IGF-1 levels was associated with a significantly lower incidence of type 2 diabetes (HR: 0.40, p=0.037).
• IGF-1 levels showed no association with post-ACS myocardial infarct size or cardiac dysfunction.

Conclusions:

• Admission IGF-1 levels may serve as a predictor for type 2 diabetes in hyperglycemic ACS patients.
• IGF-1 levels do not appear to be a reliable predictor of long-term cardiovascular outcomes, myocardial infarct size, or cardiac dysfunction in this patient cohort.