Abstract 9383: Galectin-3 and Long-term Mortality in Patients with Acute Heart Failure
Background:Galectin-3 (gal-3), a β-galactoside-binding lectin macrophage product, is upregulated in models of cardiac hypertrophy, before the onset of HF and promotes fibrosis. We have shown that gal-3 levels predict short-term mortality in acute destabilized HF (ADHF). However, the relationship between gal-3 and long-term mortality in ADHF is unknown.
Methods: 181 subjects with ADHF from the Pro-BNP Investigation of Dyspnea in the Emergency Department study were examined; gal-3 levels were measured with a novel assay, and univariate and multivariate Cox regression analysis was used to determine association between gal-3 level and long-term mortality.
Results: In patients with ADHF, there was a significant, continuous relationship between gal-3 level and 4-year mortality. In univariate Cox regression models, gal-3 emerged as an independent predictor of death at 4 years (hazard ratio HR = 3.03, 95% confidence interval CI 1.94–4.73; P< .001). In a multivariate Cox regression model including traditional markers of clinical risk (including age, NT-proBNP or C-reactive protein level, functional class, or renal function), gal-3 remained an independent predictor of death at 4 years (HR = 1.84, 95% CI 1.04–3.28; P= .04). In a Kaplan-Meier survival analysis, gal-3 level was significantly additive to natriuretic peptide levels in predicting risk of death at 4 years in patients with acute HF (log-rank P< .001). Using cutoffs determined by ROC analysis, patients with gal-3 and NT-proBNP higher than the cutoff level experienced a significantly higher mortality (Figure, panel A) at 4 years, or combined mortality or re-hospitalization at 4 years (P< .001; Figure, panel B). Patients with gal-3 and NT-proBNP lower than the cutoff experienced the best outcomes.
Conclusions: Among patients with ADHF, gal-3 concentrations during index admission predicted mortality to four years, independent of and additive to traditional clinical and biochemical markers of risk.
- © 2010 by American Heart Association, Inc.