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(Circulation. 1996;94:2465-2471.)
© 1996 American Heart Association, Inc.

Articles

Lanreotide Reduces Serum Free and Total Insulin-Like Growth Factor-I After Angioplasty

Jan Frystyk, MD, PhD; Christian Skjærbæk, MD; Niels Alexander, VET; Håkan Emanuelsson, MD, PhD; Harry Suryapranata, MD, PhD; Horst Beyer; Marie Foegh, MD, DSc; Hans Ørskov, MD, DSc

the Institute of Experimental Clinical Research, Aarhus (Denmark) University Hospital, Kommunehospitalet (J.F., C.S., H.Ø.); IPSEN ApS, Copenhagen, Denmark (N.A.); the Department of Cardiology, Sahlgrenska Sjukhuset, Goteborg, Sweden (H.E.); the Department of Cardiology, Hospital de Weezenlanden, Zwolle, the Netherlands (H.S.); the Department of Cardiology, Waldkrankenhaus St. Marien, Erlangen, Germany (H.B.); and Georgetown University Medical Center and Henri Beaufour Institute-USA (M.F.).

Correspondence to Jan Frystyk, MD, Institute of Experimental Clinical Research, Aarhus Kommunehospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark.

Background Several experiments point to a participating role of insulin-like growth factor-I (IGF-I) in the vascular events leading to restenosis after percutaneous transluminal coronary angioplasty (PTCA).

Methods and Results We measured fasting serum total (extractable) IGF-I in 553 patients in a controlled clinical trial. Half of the patients received continuous subcutaneous infusion of the somatostatin analogue lanreotide from the day before (baseline) and for 4 days after PTCA. We also measured ultrafiltrated serum free IGF-I and IGF-II, total IGF-II, IGF-binding protein-1 (IGFBP-1), IGFBP-3, and insulin in a subgroup of 18 placebo-treated and 20 lanreotide-treated patients. Total IGF-I had decreased by 7% (P<.0001) 1 day after initiation of lanreotide infusion and stayed reduced, whereas no early changes occurred in placebo-treated patients. The same pattern was observed in the subgroup. Free IGF-I decreased significantly from baseline by 22% to 27% (P<.05) in lanreotide-treated patients and increased insignificantly by 10% to 30% (P=.054) in placebo-treated patients. IGFBP-1 increased (P<.05) in both groups postoperatively, but levels in lanreotide-treated patients exceeded (P<.05) those of placebo-treated patients. Lanreotide treatment resulted in minor reductions (P<.05) in free and total IGF-II and IGFBP-3, whereas insulin was unaltered.

Conclusions Lanreotide administration acutely decreases circulating total and free IGF-I, the latter relatively more, and increases IGFBP-1. These alterations in the IGF system may participate in the improvement of the long-term outcome after PTCA noted with lanreotide treatment.

Key Words: growth substances • proteins • angiography • muscle, smooth

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