Serum insulin-like growth factor I and risk for heart failure in elderly individuals without a previous myocardial infarction: the Framingham Heart Study

Ann Intern Med. 2003 Oct 21;139(8):642-8. doi: 10.7326/0003-4819-139-8-200310210-00007.


Background: Several experimental investigations have emphasized the favorable effects of insulin-like growth factor I (IGF-I) on left ventricular remodeling, partly through its antiapoptotic effects. Cross-sectional clinical studies have reported that low serum IGF-I levels in patients with heart failure correlate with cachexia and severity of ventricular dysfunction. It is unclear whether low serum IGF-I is a risk factor for heart failure.

Objective: To prospectively study the association between serum IGF-I level and the incidence of congestive heart failure.

Design: Community-based, prospective cohort study.

Setting: Framingham, Massachusetts.

Participants: 717 elderly individuals (mean age, 78.4 years; 67% women) who did not have myocardial infarction and congestive heart failure at baseline.

Measurement: Incidence of a first episode of congestive heart failure on follow-up.

Results: During follow-up (mean, 5.2 years), 56 participants (35 women) developed congestive heart failure. In multivariable Cox regression models adjusting for established risk factors at baseline, there was a 27% decrease in risk for heart failure for every 1 standard deviation increment in log IGF-I. Individuals with serum IGF-I level at or above the median value (140 microg/L) had half the risk for heart failure (hazard ratio, 0.49 [95% CI, 0.26 to 0.92]) of those with serum IGF-I levels below the median. These comparisons were maintained in analyses adjusting for the occurrence of a myocardial infarction on follow-up.

Conclusions: In our prospective, community-based investigation, serum IGF-I level was inversely related to the risk for congestive heart failure in elderly people without a previous myocardial infarction. Additional investigations are warranted to confirm these findings.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Female
  • Heart Failure / blood*
  • Heart Failure / epidemiology*
  • Heart Failure / physiopathology
  • Humans
  • Incidence
  • Insulin-Like Growth Factor I / metabolism*
  • Male
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Ventricular Remodeling / physiology


  • Insulin-Like Growth Factor I