Immunoreactive Serum Insulin and Growth Hormone Response in Patients with Preinfarction Angina and Acute Myocardial Infarction

¹ Assistant Chief, Cardiology Section, West Side Veterans Administration Hospital; Assistant Professor of Medicine, The Abraham Lincoln School of Medicine, University of Illinois College of Medicine, Chief, Cardiac Non-Invasive Laboratory, VA Hospital, and Adjunct Assistant Professor of Medicine, University of California College of Medicine, Irvine
² Cardiology Section, West Side Veterans Administration Hospital

Levels of fasting growth hormone (GH), immunoreactive insulin (IRI) and glucose (FBS) were determined in 18 patients with acute myocardial infarction (AMI) and six patients with preinfarction angina on the day of admission to the hospital. The GH levels were within normal limits for the patients with AMI and preinfarction angina. Five of 18 patients with AMI and three of six patients with preinfarction angina had elevated levels of IRI, and one of 18 patients with AMI had IRI values below normal. None of the patients with preinfarction angina had hyperglycemia, but eight of 18 patients with AMI (44 percent) had elevated FBS levels. Of these eight patients with hyperglycemia, two had elevated IRI levels and six had values within normal limits. Thus, hyperglycemia in the two patients with elevated IRI levels was not attributable to hypoinsulinemia, but was due to other factors. The IRI levels did not correlate well with arrhythmias, Peel's prognostic score, clinical failure or cardiomegaly. GH levels were within normal limits in patients with AMI as well as preinfarction angina, and all survived. It is concluded that fasting-GH and IRI levels are similar in patients with AMI, and preinfarction angina and may indirectly indicate an equal degree of stress in these two disease states. Secondly, the presence of hyperglycemia in patients with AMI is not always related to insulin suppression, and may be due to other factors.