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Utility of galectin-3 as a prognostic biomarker in heart failure: where do we stand?
Varsha Srivatsan1, Melvin George2, Elangovan Shanmugam1
1Department of Cardiology, SRM Medical College Hospital and Research Centre, India.
Insights
Galectin-3 is not a reliable predictor of mortality in heart failure (HF) patients. However, combining galectin-3 with other biomarkers may improve prognostic accuracy for HF.
Area of Science:
- Cardiology
- Biomarker Research
- Systematic Review
Background:
- Heart failure (HF) has high mortality rates, necessitating effective prognostic biomarkers.
- Galectin-3 has been investigated as a novel prognostic biomarker in HF, but results are conflicting.
Purpose of the Study:
- To systematically review the utility of galectin-3 as a prognostic biomarker in heart failure populations.
Main Methods:
- A systematic literature search was conducted across multiple databases.
- Inclusion/exclusion criteria were used to select 27 original articles for review.
Main Results:
- Multivariate analysis indicated galectin-3 is ineffective for predicting mortality, especially when influenced by eGFR, LVEF, and NTproBNP.
- Galectin-3 did not outperform NTproBNP, sST2, GDF-15, or CRP in mortality prediction.
- Combining natriuretic peptides with galectin-3 showed superior mortality prediction compared to individual biomarkers.
Conclusions:
- Current evidence does not support galectin-3 as an independent predictor of mortality in heart failure.
- Assessing galectin-3 within a multi-biomarker panel may offer improved prognostication for HF patients.
Background:
Heart failure (HF) continues to be an illness of daunting proportions with a four- year mortality touching 50%. Biomarkers for prognosticating patients with heart failure have generated immense interest. Several studies have been conducted on a novel biomarker, galectin-3 to assess its prognostic effect in heart failure populations. However, the studies have generated conflicting results. Hence a systematic review was done to assess the utility of galectin-3 as a prognostic biomarker in HF.
Design:
This study was a systematic review.
Methods:
A literature search was done using terms 'galectin-3 and heart' and 'galectin-3 and heart failure' in MEDLINE, Science Direct, Scopus, Springer Link, Cochrane Library and Google Scholar for original articles using a predefined inclusion/exclusion criteria.
Results:
Altogether 27 original articles were selected for the systematic review. Multivariate analysis showed galectin-3 to be ineffective in predicting all-cause mortality and cardiovascular mortality especially under the influence of factors such as estimated glomerular filtration rate (eGFR), left ventricular ejection fraction (LVEF) and N-terminal pro-B-type natriuretic peptide (NTproBNP). Galectin-3 was not found to be superior to NTproBNP, sST2, GDF-15 or C-reactive protein (CRP) as a predictor of mortality. However the combination of natriuretic peptides and galectin-3 has been observed to be superior in predicting mortality compared to either of the biomarkers alone. The role of galectin-3 in remodelling has not been conclusively proven as seen in earlier pre-clinical studies.
Conclusion:
The current weight of evidence does not suggest galectin-3 to be a predictor of mortality. However, assessment of galectin-3 in a multi-biomarker panel may have a distinct advantage in prognosticating patients with heart failure.
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