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The prognostic value of sST2 and galectin-3 considering different aetiologies in non-ischaemic heart failure
David Binas1, Hanna Daniel2, Anette Richter1
1Department of Internal Medicine and Cardiology, Philipps-University Marburg, Marburg, Germany.
Insights
Soluble ST2 (sST2) predicts mortality in non-ischaemic dilated cardiomyopathy (DCM) heart failure. Intermediate galectin-3 levels may indicate a better prognosis for these patients.
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure Research
Background:
- Soluble ST2 (sST2) and galectin-3 are known prognostic markers in heart failure (HF).
- Previous research primarily focused on ischaemic causes of HF.
- The prognostic role of sST2 and galectin-3 in non-ischaemic dilated cardiomyopathy (DCM) requires further investigation.
Purpose of the Study:
- To investigate the prognostic value of sST2 and galectin-3 in patients with non-ischaemic DCM.
- To assess the association of these biomarkers with all-cause mortality (ACM) and cardiac mortality (CM).
Main Methods:
- Serum concentrations of sST2 and galectin-3 were measured in 262 DCM patients.
- Survival analysis was performed to determine rates of ACM and CM.
- Univariate and multivariate analyses were conducted, along with subgroup analyses for inflammatory/viral and idiopathic DCM.
Main Results:
- sST2 was a significant predictor of ACM and CM in univariate and multivariate analyses.
- In patients with inflammatory/viral DCM, sST2 strongly predicted both ACM and CM.
- While continuous galectin-3 showed no significance, intermediate levels were associated with lower ACM and CM rates.
Conclusions:
- sST2 is a valuable predictor of mortality in non-ischaemic heart failure, particularly in patients with an inflammatory background.
- Novel findings suggest intermediate galectin-3 levels may indicate a better prognosis in DCM patients.
- These biomarkers could aid in risk stratification for non-ischaemic DCM.
Objective:
Several studies indicate a prognostic value of sST2 and galectin-3 in heart failure (HF). While previous studies focused on ischaemic cause of HF, we investigated the role of sST2 and galectin-3 in patients with non-ischaemic dilated cardiomyopathy (DCM).
Methods:
sST2 and galectin-3 serum concentrations were measured in 262 subjects with DCM. Survival rates were determined for all-cause mortality (ACM) and cardiac mortality (CM).
Results:
In a univariate model, sST2 as a continuous variable was a predictor of ACM (HR 1.05; 95% CI 1.03 to 1.07, P<0.001) and CM (HR 1.03; 95% CI 1.00 to 1.06, P=0.040). In the subgroup of patients with inflammatory and/or viral DCM (DCMi⋎viral), the endpoints ACM (HR 1.10; 95% CI 1.05 to 1.17, P<0.001) and CM (HR 1.10; 95% CI 1.02 to 1.18, P=0.013) were significant. In the subgroup of patients with idiopathic DCM, the endpoint ACM (HR 1.04; 95% CI 1.01 to 1.07, P=0.019) was significant. In a multivariate model, the prognostic value of the sST2 main group remained intact for ACM (HR 1.04; 95% CI 1.02 to 1.07, P=0.003).Univariate and multivariate analysis of galectin-3 as continuous variable did not show any significant result. However, in a quartile model, intermediate values of galectin-3 were significantly associated with a lower event rate of ACM and CM.
Conclusion:
The study revealed that sST2 predicts ACM and CM in patients with non-ischaemic HF and could be useful especially in patients with inflammatory background. Our findings that intermediate levels of galectin-3 allow for better prognosis were new and different to other investigations.
Trial Registration Number:
NCT03090425; Results.
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