Abstract 10012: Galectin-3 is a Strong Early Predictor of Mortality in Severe Congestive Heart Failure
Background: Galectin-3 (Gal-3) is a carbohydrate binding lectin produced by macrophages, upregulated in hypertrophied heart, emerging as an important mediator for fibrosis development and cardiac remodeling. The purpose of this study was to assess the survival prognostic value of Gal-3 in patients with severe congestive heart failure (CHF).
Methods: Gal-3 circulating concentrations were measured in 73 fully treated HF patients, and the risk-adjusted survival was analyzed over a 6-year follow-up period. Patients' characteristics: mean age: 68 ±13 years; males n=56, females n=17; ejection fraction: 22± 6%; NYHA II-IV; etiology: ischemic n=54, dilated cardiomyopathy n=19.The Gal-3 concentrations were determined with an optimized enzyme-linked immunosorbent assay (BG Medicine, Waltham, MA, USA). Survival curves of patients with Gal-3 below and above the median were compared by the Kaplan-Meier method (Log-Rank test).
Results: During follow-up, 43 patients died (worsening HF n=29; sudden death n=11; other cardiovascular death n=3) and 6 patients underwent a heart transplant. Twenty-four patients were alive at the end of follow-up. Geometric mean [95% CI] of Gal-3 was higher in CHF 18.6 ng/mL [7.9-49.6] than in controls 10.3 ng/mL [4.7-18.9] (p < 0.0001). Time to 25% events rate were 130 days for subgroup with Gal-3 levels above the median (17 ng/mL) and 844 days for the subgroup with values below the median (see figure). Both survival curves differed significantly (Log-Rank=0.0053).
Conclusions: Galectin-3 identifies patients with very early risk of death from worsening heart failure or sudden death in whom more aggressive treatments (ICD, CRT and LVADs) can be targeted.
- © 2011 by American Heart Association, Inc.