Galectin-3, Acute Kidney Injury and Myocardial Damage in Patients With Acute Heart Failure
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Published on: July 14, 2023
Y U Horiuchi1, Nicholas Wettersten2, Dirk J VAN Veldhuisen3
1Division of Cardiovascular Medicine, University of California San Diego, La Jolla, CA, USA; Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.
Insights
Higher galectin-3 levels in acute heart failure (AHF) patients indicate kidney and heart injury. This biomarker predicts worse outcomes, including increased mortality risk.
Area of Science:
- Cardiology
- Nephrology
- Biomarker Research
Background:
- Galectin-3 is a known biomarker for inflammation and fibrosis.
- It has been linked to renal and myocardial damage in acute heart failure (AHF).
Purpose of the Study:
- To investigate the association between galectin-3 levels and renal/myocardial injury in AHF patients.
- To evaluate galectin-3 as a predictor of outcomes in AHF.
Main Methods:
- Retrospective analysis of 790 AHF patients from the AKINESIS study.
- Assessed acute kidney injury (KDIGO), renal tubular damage (uNGAL), and myocardial injury (hs-cTnI).
- Used multivariable regression and Cox analysis to determine associations with outcomes.
Main Results:
- Elevated galectin-3 (> 25.9 ng/mL) correlated with higher rates of acute kidney injury, renal tubular damage, and myocardial injury.
- Galectin-3 showed negative association with estimated glomerular filtration rate and positive association with uNGAL and hs-cTnI.
- Higher galectin-3 predicted in-hospital mortality and was associated with increased 1-year mortality risk, particularly death alone after adjustment.
Conclusions:
- In AHF patients, elevated galectin-3 is associated with renal dysfunction, renal tubular damage, and myocardial injury.
- Higher galectin-3 levels serve as a predictor of adverse outcomes, including mortality.
Background:
Galectin-3, a biomarker of inflammation and fibrosis, can be associated with renal and myocardial damage and dysfunction in patients with acute heart failure (AHF).
Methods And Results:
We retrospectively analyzed 790 patients with AHF who were enrolled in the AKINESIS study. During hospitalization, patients with galectin-3 elevation (> 25.9 ng/mL) on admission more commonly had acute kidney injury (assessed by KDIGO criteria), renal tubular damage (peak urine neutrophil gelatinase-associated lipocalin [uNGAL] > 150 ng/dL) and myocardial injury (≥ 20% increase in the peak high-sensitivity cardiac troponin I [hs-cTnI] values compared to admission). They less commonly had ≥ 30% reduction in B-type natriuretic peptide from admission to last measured value. In multivariable linear regression analysis, galectin-3 was negatively associated with estimated glomerular filtration rate and positively associated with uNGAL and hs-cTnI. Higher galectin-3 was associated with renal replacement therapy, inotrope use and mortality during hospitalization. In univariable Cox regression analysis, higher galectin-3 was associated with increased risk for the composite of death or rehospitalization due to HF and death alone at 1 year. After multivariable adjustment, higher galectin-3 levels were associated only with death.
Conclusions:
In patients with AHF, higher galectin-3 values were associated with renal dysfunction, renal tubular damage and myocardial injury, and they predicted worse outcomes.
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