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Levels and Change in Galectin-3 and Association With Cardiovascular Events: The ARIC Study
David Aguilar1, Caroline Sun, Ron C Hoogeveen2,3
1Department of Epidemiology, Human Genetics, and Environmental Sciences School of Public Health University of Texas Health Science Center at Houston TX.
Insights
Higher galectin-3 levels in midlife and older adults are linked to increased risk of heart failure, stroke, coronary heart disease, and mortality. A rise in galectin-3 over time further elevates cardiovascular event risk.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Epidemiology
Background:
- Circulating galectin-3 offers prognostic value in established heart failure (HF).
- Associations between galectin-3 and incident cardiovascular events in asymptomatic midlife individuals are not well-characterized.
- Longitudinal changes in galectin-3 and their association with cardiovascular risk require further investigation.
Purpose of the Study:
- To investigate the association between plasma galectin-3 levels and incident cardiovascular events in asymptomatic individuals at midlife.
- To examine the association between galectin-3 levels measured approximately 15 years later and incident cardiovascular events.
- To assess the impact of changes in galectin-3 levels over time on cardiovascular risk.
Main Methods:
- Utilized multivariable Cox proportional hazards models.
- Analyzed data from the Atherosclerosis Risk in Communities (ARIC) study, including participants free of cardiovascular disease at visits 4 and 5.
- Assessed plasma galectin-3 levels at midlife (visit 4) and older age (visit 5) and their association with incident coronary heart disease, ischemic stroke, HF hospitalization, and total mortality.
Main Results:
- Higher galectin-3 at midlife (visit 4) was independently associated with increased risk of coronary heart disease, ischemic stroke, HF, and mortality.
- At older age (visit 5), higher galectin-3 was associated with increased risk of HF and total mortality, but not coronary heart disease or stroke.
- A significant increase in galectin-3 levels from midlife to older age was associated with a higher risk of incident HF and total mortality.
Conclusions:
- Plasma galectin-3 measured at midlife and older age is associated with an elevated risk of cardiovascular events in a large, biracial community cohort.
- Increasing galectin-3 levels over a 15-year period also indicate a heightened risk for cardiovascular events, including HF and mortality.
- Galectin-3 may serve as a valuable biomarker for predicting cardiovascular risk in asymptomatic individuals across different life stages.
Abstract:
Background Circulating galectin-3 levels provide prognostic information in patients with established heart failure (HF), but the associations between galectin-3 levels and other incident cardiovascular events in asymptomatic individuals at midlife and when remeasured ≈15 years later are largely uncharacterized. Methods and Results Using multivariable Cox proportional hazards models, we identified associations between plasma galectin-3 levels (hazard ratio [HR] per 1 SD increase in natural log galectin-3) and incident coronary heart disease, ischemic stroke, HF hospitalization, and total mortality in ARIC (Atherosclerosis Risk in Communities) participants free of cardiovascular disease at ARIC visit 4 (1996-1998; n=9247) and at ARIC visit 5 (2011-2013; n=4829). Higher galectin-3 level at visit 4 (median age 62) was independently associated with incident coronary heart disease (adjusted HR, 1.30; 95% CI, 1.06-1.60), ischemic stroke (HR, 1.42; 95% CI, 1.01-2.00), HF (HR, 1.44; 95% CI, 1.17-1.76), and mortality (HR, 1.56; 95% CI, 1.35-1.80). At visit 5 (median age, 74), higher galectin-3 level was associated with incident HF (HR, 1.93; 95% CI, 1.15-3.24) and total mortality (HR, 1.70; 95% CI, 1.15-2.52), but not coronary heart disease or stoke. Individuals with the greatest increase in galectin-3 levels from visit 4 to visit 5 were also at increased risk of incident HF and total mortality. Conclusions In a large, biracial community-based cohort, galectin-3 measured at midlife and older age was associated with increased risk of cardiovascular events. An increase in galectin-3 levels over this period was also associated with increased risk.
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