Impact of insulin like growth factor-1 in development of coronary artery ectasia

Abstract

Coronary artery ectasia (CAE) is characterized by inappropriate dilatation of the coronary vasculature. The mechanisms of CAE are not well known. Insulin-like growth factor-1 (IGF-1) may make endothelial cells and smooth muscle cells more sensitive to the effects of growth hormone. In the present study, we hypothesized that IGF-1 may have an impact on the formation of ectasia and aneurysm in arterial system, and aimed to investigate the associations between the presence of CAE and serum IGF-1 levels in patients undergoing coronary angiography. The study included 2.980 subjects undergoing elective diagnostic coronary angiography. We selected 40 patients diagnosed with CAE as CAE group and 44 subjects with absolutely normal coronary arteries were assigned as normal control group. IGF-1 levels were measured in both groups of patients. Groups were similar in terms of age, sex and coronary artery disease risk factors. The serum IGF-1 levels were significantly higher in CAE patients with 109.64 ± 54.64 ng/mL than in controls with 84.76 ± 34.01 ng/mL (p=0.016). HDL levels were lower in ectasia group with 41.5 ± 10.7 mg/dL than controls with 47.7 ± 10.4 mg/dL (p=0.018). By means of logistic regression analysis, high IGF-1 and low HDL levels were found to be independent risk factors for the presence of CAE (p<0.02, p<0.016, respectively). The study revealed that there was a positive correlation between serum IGF-1 levels and presence of CAE, and high IGF-1 levels and low HDL levels were independent risk factors for the presence of CAE. Future studies are needed to confirm these results.

Coronary Artery Ectasia: An Insight into Intraprocedural and Postprocedural Management Strategies

“…In one study, a reduced level of Vitamin D was shown to be associated with CAE [ 5 ]. However, exaggerated inflammation, as seen in the form of either the human immunodeficiency virus (HIV) infection alone [ 6 ] or higher levels of uric acid (UA) and high sensitivity CRP (Hs-CRP) [ 7 ], elevated monocytes to high-density lipoprotein ratio (MHR) [ 8 ], a high neutrophil to lymphocyte (N/L) ratio [ 9 ], elevated insulin-like growth factor I (IGF-I) level [ 10 ], or high levels of inflammatory cytokines (i.e., IL-1b, tumor necrosis factor alpha (TNF-α), and interleukin 10 (IL-10) [ 11 ]), has been the main inciting factor in CAE development and progression. CAE often presents as exercise-induced angina; however, it is not uncommon to present as ACS as well [ 12 - 13 ].…”

Insulin-Like Growth Factor 1 Under Conditions of the Brain Vascular Diseases

“…Концентрація ІФР-1 в стінці аневризм знижується, що вказує на потенційну роль цього чинника у механізмах регулювання метаболізму цього білка [26,27]. Інший можливий механізм формування аневризм і ектазій артерій -підвищена чутливість ендотеліальних і гладеньком'язових клітин до дії ГР під впливом ІФР-1 [28].…”