Galectin-3 Is Associated With Risk of Cardiovascular and Kidney Outcomes in Ambulatory Veterans

Cardiovascular and kidney disease are highly prevalent comorbid conditions, and each is a risk factor for the other condition. We evaluated whether Galectin-3 (Gal-3), a biomarker of organ fibrosis, is associated with cardiovascular and kidney events in ambulatory Veterans.

An observational cohort study.

Ambulatory Veterans presenting for an outpatient echocardiogram at the San Diego Veterans Affairs between 2010 and 2013.

Blood Gal-3 levels.

The primary cardiovascular outcome was major adverse cardiac events (MACEs: acute coronary syndrome [ACS], stroke, heart failure [HF] hospitalization, or cardiovascular death). The primary kidney outcome was major adverse kidney events (MAKEs: ≥40% estimated glomerular filtration rate decrease or renal replacement therapy). Secondary outcomes were cardiovascular death, incident HF, ACS, and all-cause mortality.

Cox proportional hazard models adjusting for cardiovascular and kidney disease risk factors.

A total of 882 Veterans with an average age of 66 ± 12 years, 97% were men, average eGFR of 78 ± 20 mL/min/1.73 m², 40% prevalence of coronary artery disease, and 17% prevalence of HF. Higher Gal-3 was associated with a greater risk of MACEs (hazard ratio [HR], 1.54 per 2-fold higher Gal-3; 95% confidence interval [CI], 1.02-2.32; P = 0.04), cardiovascular death (HR, 3.41; 95% CI, 1.75-6.66; P < 0.001), and all-cause mortality (HR, 1.81; 95% CI, 1.41-2.33; P < 0.001), but not incident HF or ACS. Higher Gal-3 was associated with a greater risk of MAKEs (HR, 1.92; 95% CI, 1.20-3.08; P = 0.004). Higher Gal-3 was associated with >350% greater risk of experiencing both MACEs and MAKEs during follow-up (HR, 3.57; 95% CI, 1.63-7.84; P = 0.002).

Select population of Veterans presenting for an echocardiogram who were primarily older men with multiple comorbid conditions.

Gal-3 is associated with risk of cardiovascular and kidney outcomes among ambulatory Veterans.