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Predictive value of plasma galectin-3 levels in heart failure with reduced and preserved ejection fraction
Rudolf A de Boer1, Dirk J A Lok, Tiny Jaarsma
1Department of Cardiology, University Medical Centre Groningen, University of Groningen, PO Box 30 001, Hanzeplein 1, 9700 RB, Groningen, The Netherlands. r.a.deboer@thorax.umcg.nl
Insights
Galectin-3 is an independent predictor of outcomes in heart failure (HF) patients. This biomarker is especially valuable for predicting prognosis in individuals with preserved ejection fraction (HFpEF).
Area of Science:
- Cardiology
- Biomarker Research
- Heart Failure Pathophysiology
Background:
- Galectin-3 has emerged as a potential biomarker for heart failure (HF).
- Previous studies on galectin-3 in HF cohorts were limited in size and scope, primarily focusing on systolic HF.
- The prognostic value of galectin-3 across different left ventricular ejection fraction (LVEF) statuses requires further investigation.
Purpose of the Study:
- To evaluate the prognostic significance of baseline galectin-3 levels in a large, diverse heart failure cohort.
- To compare the predictive capabilities of galectin-3 against other established biomarkers.
- To assess the utility of galectin-3 in patients with both preserved and reduced LVEF.
Main Methods:
- A cohort of 592 hospitalized heart failure patients was prospectively followed for 18 months.
- The primary endpoint combined all-cause mortality and HF re-hospitalization.
- Galectin-3 levels were analyzed at baseline and, in a subset, at 6 months; comparisons were made with other biomarkers like BNP, IL-6, CRP, and eGFR.
Main Results:
- A twofold increase in galectin-3 was associated with a 97% higher risk of the primary outcome (HR 1.97).
- Even after multivariable adjustment (including age, gender, BNP, eGFR, diabetes), galectin-3 remained an independent predictor (HR 1.38).
- Galectin-3 showed stronger predictive value in patients with preserved LVEF compared to those with reduced LVEF and correlated positively with IL-6 and CRP.
Conclusions:
- Galectin-3 serves as an independent prognostic marker for adverse outcomes in heart failure patients.
- Its predictive utility is particularly pronounced in heart failure with preserved ejection fraction (HFpEF).
- Combining galectin-3 with BNP may enhance prognostic accuracy beyond individual biomarkers.
Aims:
galectin-3 is an emerging biomarker which has been studied in relatively small heart failure (HF) cohorts with predominantly systolic HF. We studied the prognostic value of base-line galectin-3 in a large HF cohort, with preserved and reduced left ventricular ejection fraction (LVEF), and compared this to other biomarkers.
Methods:
we studied 592 HF patients who had been hospitalized for HF and were followed for 18 months. The primary end-point was a composite of all-cause mortality and HF hospitalization.
Results:
a doubling of galectin-3 levels was associated with a hazard ratio (HR) of 1.97 (1.62-2.42) for the primary outcome (P < 0.001). After correction for age, gender, BNP, eGFR, and diabetes the HR was 1.38 (1.07-1.78; P = 0.015). Galectin-3 levels were correlated with higher IL-6 and CRP levels (P < 0.002). Changes of galectin-3 levels after 6 months did not add prognostic information to the base-line value (n = 291); however, combining plasma galectin-3 and BNP levels increased prognostic value over either biomarker alone (ROC analysis, P < 0.05). The predictive value of galectin-3 was stronger in patients with preserved LVEF (n = 114) compared to patients with reduced LVEF (P < 0.001).
Conclusions:
galectin-3 is an independent marker for outcome in HF and appears to be particularly useful in HF patients with preserved LVEF.
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