• Intern Emerg Med · Sep 2022

    Insulin-like growth factor-1 (IGF-1) as predictor of cardiovascular mortality in heart failure patients: data from the T.O.S.CA. registry.

    • Alfredo De Giorgi, Alberto Maria Marra, Massimo Iacoviello, Vincenzo Triggiani, Giuseppe Rengo, Francesco Cacciatore, Ciro Maiello, Giuseppe Limongelli, Daniele Masarone, Francesco Perticone, FilardiPasquale PerronePPDepartment of Advanced Biomedical Sciences, Federico II University, Naples, Italy.Mediterranea Cardiocentro, Naples, Italy., Stefania Paolillo, Antonio Mancini, Maurizio Volterrani, Olga Vriz, Roberto Castello, Andrea Passantino, Michela Campo, Pietro Amedeo Modesti, Andrea Salzano, Roberta D'Assante, Michele Arcopinto, Valeria Raparelli, Fabio Fabbian, Angela Sciacqua, Annamaria Colao, Toru Suzuki, Eduardo Bossone, Antonio Cittadini, and T.O.S.CA. Investigators.
    • Clinica Medica Unit, Azienda Ospedaliero-Universitaria S.Anna, Ferrara, Italy. alfredo.degiorgi@unife.it.
    • Intern Emerg Med. 2022 Sep 1; 17 (6): 1651-1660.

    IntroductionData 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.MethodsAt 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.Results337 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.ConclusionsOur study showed the clinical and prognostic utility of the IGF-1 assay in patients with HF.© 2022. The Author(s).

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