Horm Metab Res 2019; 51(02): 112-119
DOI: 10.1055/a-0794-6163
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Free IGF-1, Intact IGFBP-4, and PicoPAPP-A are Altered in Acute Myocardial Infarction Compared to Stable Coronary Artery Disease and Healthy Controls

Athanasios D. Anastasilakis
1   Department of Endocrinology, 424 General Military Hospital, Thessaloniki, Greece
,
Dimitrios Koulaxis
2   Department of Cardiology, 424 General Military Hospital, Thessaloniki, Greece
,
Jagriti Upadhyay
3   Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
4   Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA, USA
,
Eirini Pagkalidou
5   Department of Hygiene and Epidemiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
,
Nikoleta Kefala
2   Department of Cardiology, 424 General Military Hospital, Thessaloniki, Greece
,
Nikolaos Perakakis
3   Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
,
Stergios A. Polyzos
6   First Department of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
,
Fotios Economou
2   Department of Cardiology, 424 General Military Hospital, Thessaloniki, Greece
,
Christos S. Mantzoros
3   Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
› Author Affiliations
Further Information

Publication History

received 13 March 2018

accepted 05 November 2018

Publication Date:
29 November 2018 (online)

Abstract

Insulin-like growth factor-1 (IGF-1) and its binding proteins have been implicated in the pathophysiology of coronary artery disease (CAD) and myocardial infarction (MI). We investigated components of the IGF-1 system in circulation at the time of acute MI and following reperfusion in relation to levels of stable CAD patients and controls. Patients with MI (MI Group, n=31) treated with percutaneous coronary intervention (PCI) were compared to patients with stable CAD subjected to scheduled PCI (CAD Group, n=40) and controls with symptoms mimicking CAD without stenosis in angiography (Control Group, n=43). The number and extent of stenosis were recorded. Total and free IGF-1, total and intact IGF binding protein (IGFBP)-3 and -4, pico-Pregnancy Associated Plasma Protein-A (PAPP-A), and the known markers ALT, AST, CK and CK-MB were measured at baseline and 6 or 24 h after the intervention. Patients with MI had higher free IGF-1 (p=0.003) and PAPP-A (p=0.011), but lower intact IGFBP-4 (p=0.006) compared with patients with stable CAD or healthy controls. None of the investigated molecules changed following reperfusion or correlated with the extent of stenosis. AST (p<0.001), CK (p<0.001) and CK-MB (p<0.001), were also higher. Free IGF-1, intact IGFBP-4 and PAPP-A could predict MI, but with lower accuracy than CK-MB. In conclusion, free IGF-1 levels are higher in MI compared to CAD patients and controls and this could result from increased cleavage of its binding protein IGFBP-4 by the higher PAPP-A levels. Free IGF-1, intact IGFBP-4, and/or PAPP-A are inferior to CK-MB as predictors or markers of myocardial damage.

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