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Galectin-3 and incidence of atrial fibrillation: The Atherosclerosis Risk in Communities (ARIC) study
Oluwaseun E Fashanu1, Faye L Norby1, David Aguilar2
1Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
Insights
Elevated galectin-3 levels are linked to a higher risk of developing atrial fibrillation (AF). This association may be mediated through pathways involving coronary heart disease (CHD) and heart failure (HF).
Area of Science:
- Cardiology
- Biomarkers
- Epidemiology
Background:
- Galectin-3 is a lectin implicated in inflammation and fibrosis.
- Its role in atrial fibrillation (AF) etiology is under investigation.
Purpose of the Study:
- To investigate the association between plasma galectin-3 levels and the risk of incident AF.
- To explore potential mediating roles of coronary heart disease (CHD) and heart failure (HF).
Main Methods:
- 8,436 participants without AF at baseline were followed for incident AF.
- Plasma galectin-3 levels were measured at baseline.
- Multivariable Cox proportional hazards models were used, adjusting for risk factors, CHD, and HF.
Main Results:
- Higher galectin-3 levels (≥90th percentile) were associated with a significantly increased risk of incident AF.
- Hazard ratios for the highest galectin-3 levels were 1.40-1.51 compared to the lowest quartile.
- The association was attenuated and not significant after accounting for incident CHD and HF.
Conclusions:
- Elevated plasma galectin-3 is associated with an increased risk of incident AF.
- Galectin-3 may contribute to AF risk through pathways involving CHD and HF.
Background:
Galectin-3, a β-galactoside binding lectin involved in important regulatory roles in adhesion, inflammation, immunity, and fibrosis, may be relevant to atrial fibrillation (AF) etiology.
Methods:
We included 8,436 participants free of AF at baseline (1996-1998) and with measures of plasma galectin-3 from the Atherosclerosis Risk in Communities study. We ascertained incident AF through 2013 from study visit electrocardiograms, hospitalizations, and death certificates. Multivariable Cox proportional hazards models, adjusted for AF risk factors plus incident heart failure (HF) and coronary heart disease (CHD), were used to estimate hazard ratios for the association between galectin-3 and incident AF.
Results:
The mean age (SD) of participants was 62.6 (5.6) years, and the sample was comprised of 58.7% women and 21.2% blacks. During a median follow-up of 15.7 years, 1,185 incident cases of AF were observed. After adjusting for AF risk factors, participants with galectin-3 levels ≥90th percentile (19.5 ng/mL) had a significantly higher risk of incident AF when compared with the lowest quartile (4.4-11.9 ng/mL), with hazard ratios (95% CI) of 1.40 (1.04-1.89) for the 90th-<95th percentile and 1.51 (1.11-2.06) for the 95th-100th percentile. This association was attenuated and no longer statistically significant after accounting for incident CHD and HF as time-dependent variables.
Conclusions:
Elevated plasma galectin-3 is associated with increased risk of incident AF. Galectin-3 may increase AF risk via pathways involving CHD and HF.
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