Abstract 18075: Galectin-3 is Independently Associated with Cardiovascular Disease in Community-Dwelling Older Adults: The Rancho Bernardo Study

Abstract

Introduction: Galectin-3 (Gal-3) is a mediator of myocardial fibrosis and is prognostic in acute and chronic heart failure. Its association with cardiovascular disease (CVD) in the community has not been reported. We tested the hypothesis that Gal-3 is associated with CVD death and with incident CVD (coronary revascularization, myocardial infarction, or CVD death) in community-dwelling older adults.

Methods: We measured plasma Gal-3, NT-proBNP, and CRP levels in 1393 Rancho Bernardo Study participants without CVD, mean age 70, and followed them for a mean of 11 yrs.

Results: Incident CVD occurred in 254 individuals, including 169 CVD deaths. In models adjusted for traditional CVD risk factors (RFs), BMI, and creatinine clearance, Gal-3 was a significant predictor of both CVD (HR per SD log increase: 1.22, 95% CI [1.07-1.39]) and CVD death (HR 1.31 [1.11-1.54]). After further adjusting for NT-proBNP and CRP, Galectin-3 remained an independent predictor of both outcomes (Table). Gal-3 improved the c-statistic from 0.847 to 0.851 for prediction of CVD death (p=0.002). Net reclassification improvement (NRI>0) with the addition of Gal-3 was 33% (p=0.0001). Participants in the upper half of both Gal-3 and NT-proBNP had an increased risk of CVD death vs. those with only NT-proBNP elevated (HR 1.63 [1.12-2.38]) (Figure).

Conclusions: Gal-3 is a significant predictor of CVD in community-dwelling older adults, independent of traditional RFs and renal function, and adds incremental value to NT-proBNP and CRP. As both a marker and mediator of adverse cardiovascular outcomes, Gal-3 may be useful for screening and targeted interventions to prevent progression of cardiac fibrosis.