The role of insulin-like growth factor-1 in development of coronary no-reflow and severity of coronary artery disease in patients with acute myocardial infarction

Abstract

IntroductionInsulin-like growth factor-1 (IGF-1) has atheroprotective effects via reduction in oxidative stress, cellular apoptosis, pro-inflammatory signaling, and endothelial dysfunction.AimWe hypothesized that low levels of IGF-1 may be associated with the severity and extent of coronary artery disease and development of the coronary no-reflow phenomenon in patients with acute ST-elevation myocardial infarction (STEMI) and investigated the role of the IGF-1 molecule in the coronary no-reflow phenomenon and severity of coronary artery disease (CAD) in patients with acute STEMI in a tertiary hospital.Material and methodsThe study was conducted among 113 patients undergoing primary percutaneous coronary intervention (PPCI) for STEMI, of whom 49 patients developed the no-reflow phenomenon. Coronary no-reflow was defined as Thrombolysis In Myocardial Infarction (TIMI) flow grade 2 or less after intervention. Insulin-like growth factor-1 levels were measured in both groups. The severity and extent of CAD were evaluated according to the Gensini and Syntax scores.ResultsAlthough IGF-1 levels were lower in the no-reflow group, there was not a statistically significant difference between the no-reflow group and the control group (116.65 ±51.72 vs. 130.82 ±48.76, p = 0.130). Gensini and Syntax scores were higher in the no-reflow group. There was no association between Gensini and Syntax scores and IGF-1 levels (r = –0.071, r = 0.479, r = –0.158, p = 0.113).ConclusionsIn this study, IGF-1 levels were not statistically different between patients developing the no-reflow phenomenon and controls. There was no association between development of the no-reflow phenomenon and severity of CAD or IGF-1 levels. Nevertheless, large scale studies are needed to verify these results.

Role of insulin-like growth factor 1 in stent thrombosis under effective dual antiplatelet therapy

“…also reported that IGF-1 may be associated with increased fibrinogen, plasminogen activator inhibitor-1, and decreased protein S and tissue factor pathway inhibitor in acromegalic patients, which may represent a potential hypercoagulable and hypofibrinolytic state [ 40 ]. However, our results in a previous study did not show any significant association between IGF-1 levels and the development of no-reflow phenomenon in patients undergoing primary PCI for AMI [ 41 ], which may be related to the time for the measurement of IGF-1 because the level of IGF-1 may be affected by acute conditions such as inflammation [ 14 ]. Thus, IGF-1 measurement at the time of acute event may reveal uninterpretable and conflicting results.…”

Involvement of endothelial nitric oxide synthase pathway in IGF‑1 protects endothelial progenitor cells against injury from oxidized LDLs

“…Insulin-like growth factor-1 (IGF-1) and the IGF-1 receptor affect the differentiation and apoptosis of various cells (16,17). IGF-1 levels decrease during aging and are decreased in patients with CVD (18,19). A low level of IGF-1 has been identified as an independent risk factor for CVD (20,21).…”

Serum IGF-1 düzeyleri akut miyokard infarktüsü sonrası gerçekten azalır mı ve sol ventrikül disfonksiyonu ile ilişkili midir?

“…The effects of IGF are reflected via autocrine, paracrine, and endocrine routes and its regulation involves complex mechanisms. IGF-1 is transported in the blood circulation by carrier proteins that are known as IGF binding proteins (IGFBPs) (1)(2)(3)(4)(5). IGF-1 has a key role in the proliferation, modification of cells in many tissues, including the myocardium, as well as in inhibition of cell necrosis and apoptosis.…”