GHRL and heart valve disorder: In contrast, high plasma concentration of ghrelin has been shown to protect against coronary heart disease (90), and AG is significantly higher in patients with ischemic heart disease (coronary artery disease) compared to controls (valvular heart disease; 32 ± 3 vs. 16 ± 2 pg/mL) (91), potentially demonstrating a role for ghrelin in auto- and paracrine self-protective mechanisms of the ischemic heart.