Abstract 16594: Elevated Levels of Galectin-3 are Associated with Higher Levels of C-Reactive Protein, Increased Disease Severity and Poorer Prognosis in Patients with Chronic Heart Failure
Introduction Elevated levels of galectin-3 are associated with increased inflammation and fibrosis and play a role in heart failure (HF) progression. Elevated galectin-3 is also associated with increased mortality risk in patients with HF. We hypothesized that inflammation would influence the relationship between galectin-3 and HF prognosis. Therefore, we investigated the relationships between circulating levels of serum galectin-3, C-reactive protein (CRP), disease severity, functional status and prognosis in patients with chronic HF.
Methods This study included 89 patients with chronic HF (89% male/11% female; 47% Caucasian/ 52% African American/1% other). All patients had EF<40% (25%±8%), NYHA class II (73%) or III (27%) HF, but had not been hospitalized in the 30 days prior to enrollment. Mean age was 60±12, and mean 6 minute walk was 971 ft.±282 ft. Markers of fibrosis (galectin-3, ng/ml), inflammation (CRP), HF severity (NT-proBNP), functional status (6- minute walk distance), and HF prognosis (number of days until hospitalization or death) were also assessed. There were a total of 34 events (25 hospitalizations and 9 deaths) and the average duration of follow-up was 1.5 years.
Results Cox proportional hazards regression demonstrated that galectin-3 was associated with poorer HF prognosis (HR, 1.09, 95% CI, 1.03-1.149; p =.002). Elevated levels of galectin-3 were associated with advanced age (r= .29, p=.006), higher circulating levels of CRP (r=.24, p=.029), and HF severity as measured by NT-ProBNP (r=.50, p<.001). The association of galectin-3 and 6-minute walk distance did not reach statistical significance (p>.05). After adjustment for CRP the association of galectin-3 and HF prognosis was attenuated by 10% (p=.009). After further adjustment for age, gender, race, NT-proBNP, and CRP, Galectin-3 levels were associated with a 5% higher rate of hospitalization or death (p=.015).
Conclusion In conclusion, our findings suggest that elevated circulating levels of galectin-3, a novel marker of fibrosis, are associated with increased inflammation, and HF severity and poorer HF prognosis. Our data suggest that the relationship between galectin-3 and HF prognosis is mediated, at least in part, by inflammatory processes.
- © 2012 by American Heart Association, Inc.