Growth hormone for risk stratification and effects of therapy in acute myocardial infarction

Abstract

Context: Excess growth hormone (GH) is associated with early mortality.

Objectives: We assessed the association of GH with prognosis after acute myocardial infarction (AMI), and the effects of secondary prevention therapies.

Methods: GH was measured using a high-sensitivity assay in 953 AMI patients (687 males, mean age 66.1 ± 12.8 years).

Results: During 2 years follow-up, there were 281 major adverse cardiac events (MACE). Patients with MACE had higher GH levels (median [range], 0.91 [0.04–26.28] μg/L) compared to event-free survivors (0.59 [0.02–21.6], p < 0.0005). In multivariate Cox survival analysis, GH was a significant predictor of MACE (hazard ratios 1.43, p = 0.026 and 1.49, p = 0.01, respectively) with significant interactions with beta blocker therapy (p = 0.047) and angiotensin converting enzyme inhibitor or angiotensin receptor blocker (ACE/ARB) therapy (p = 0.016).

Conclusions: GH levels post-AMI are prognostic for MACE and may indicate those patients who benefit from beta blocker and ACE/ARB therapy.

• ACE inhibitors
• beta blockers
• growth hormone
• myocardial infarction

Acknowledgements

Sphingotec GmbH is a midsized company based in Hennigsdorf, Germany; it commercialises immunoassays, and has developed the hs-HG assay, for which it owns patent rights.

Declaration of interest

Dr. Bergmann holds ownership in Sphingotec AG which provided the GH assay, and is a member of the board of directors of Sphingotec GmbH. Dr. Struck is employed by Sphingotec GmbH. Dr. Ng has submitted patents on cardiovascular biomarkers on behalf of the University of Leicester. This work was supported by the John and Lucille Van Geest Foundation and the National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit.