IGF1 and ischemia reperfusion injury: IGF-1 can mediate multiple processes in cardiomyocytes, including growth, metabolism, autophagy, and apoptosis.[22,23] Studies have indicated that IGF-1 antagonizes apoptosis in rat cardiomyocytes after ischemia-reperfusion injury, in mouse myocardial infarction, and in cultivated rat cardiomyocytes.