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Galectin-3 Is Associated With Risk of Cardiovascular and Kidney Outcomes in Ambulatory Veterans
Shreya Banerjee1, Pranav S Garimella2, Kimberly N Hong3
1Department of Medicine; University of California, La Jolla, San Diego, CA.
Insights
Elevated Galectin-3 (Gal-3) levels in ambulatory Veterans are linked to increased risks of major adverse cardiac events (MACEs) and major adverse kidney events (MAKEs). This biomarker may help predict cardiovascular and kidney disease progression in this population.
Area of Science:
- Biomarker research
- Cardiovascular medicine
- Nephrology
Background:
- Cardiovascular disease and kidney disease frequently coexist and exacerbate each other.
- Galectin-3 (Gal-3) is a biomarker associated with organ fibrosis.
- The relationship between Gal-3 and clinical outcomes in ambulatory Veterans requires further investigation.
Purpose of the Study:
- To evaluate the association between Galectin-3 (Gal-3) levels and cardiovascular and kidney events in ambulatory Veterans.
- To determine if Gal-3 can serve as a predictive biomarker for adverse outcomes in this population.
Main Methods:
- An observational cohort study was conducted involving ambulatory Veterans undergoing echocardiography.
- Blood Gal-3 levels were measured as the primary predictor.
- Cox proportional hazard models were used to analyze the association with major adverse cardiac events (MACEs) and major adverse kidney events (MAKEs), adjusting for relevant risk factors.
Main Results:
- Higher Gal-3 levels were significantly associated with an increased risk of MACEs (HR 1.54), cardiovascular death (HR 3.41), and all-cause mortality (HR 1.81).
- Higher Gal-3 levels were also associated with a greater risk of MAKEs (HR 1.92).
- Elevated Gal-3 was linked to a substantially higher risk of experiencing both MACEs and MAKEs concurrently (HR 3.57).
Conclusions:
- Galectin-3 (Gal-3) is associated with an increased risk of both cardiovascular and kidney outcomes in ambulatory Veterans.
- Gal-3 may serve as a valuable biomarker for predicting adverse events in this patient group.
- Further research could explore therapeutic strategies targeting Gal-3 to mitigate cardiovascular and kidney disease progression.
Rationale & Objective:
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.
Study Design:
An observational cohort study.
Setting & Participants:
Ambulatory Veterans presenting for an outpatient echocardiogram at the San Diego Veterans Affairs between 2010 and 2013.
Predictor:
Blood Gal-3 levels.
Outcomes:
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.
Analytical Approach:
Cox proportional hazard models adjusting for cardiovascular and kidney disease risk factors.
Results:
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).
Limitations:
Select population of Veterans presenting for an echocardiogram who were primarily older men with multiple comorbid conditions.
Conclusions:
Gal-3 is associated with risk of cardiovascular and kidney outcomes among ambulatory Veterans.
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