Abstract 12199: A Novel Biomarker Galectin-3 as a Predictor of Mortality in Pulmonary Hypertension
Background: Galectin-3 (Gal-3), a novel binding-lectin involved in inflammation and fibrosis, is elevated in heart failure and is independently predictive of mortality in this condition. We recently showed that Gal-3 is significantly elevated in patients with pulmonary hypertension (PH), regardless of etiology. To date, however, no study has evaluated the prognostic role of Gal-3 in pulmonary hypertension.
Methods: Using an ELISA kit provided by BG Medicine (Waltham, MA), we measured Gal-3 levels in 76 patients with PH; 37 patients with pulmonary arterial hypertension (mean PA pressure ≥25 mmHg and PCWP ≤15 mmHg), and 39 patients with diastolic heart failure-induced pulmonary hypertension (left ventricular ejection fraction ≥50%, mean PA pressure ≥25 mmHg and gradient PA-diastolic PCWP ≤5 mmHg). Gal-3 values were evaluated in tertiles based on their distribution in the study population, and a Kaplan-Meier analysis was performed. Additionally, a Cox proportional hazards regression analysis was used to evaluate the association between Gal-3 level and the relative risk of death. Mortality rates out to 4 years were evaluated.
Results: Among the 76 patients (mean (SD) Gal-3: 29 (14.2) ng/ml), mortality rates were 16% (4/25), 34.6% (9/26), and 48% (12/25) in tertiles 1-3, respectively (p-trend=0.017). Kaplan-Meier analysis revealed a significant increase in mortality across increasing Gal-3 tertiles (log-rank p=0.014). On Cox regression analysis, Gal-3 was a strong predictor of mortality on both univariate (HR=2.09 per tertile (95% CI=1.21, 3.62 per tertile; p-trend=0.008) and multivariate analysis (HR=2.48 per tertile (95% CI=1.33, 4.60; p-trend=0.004), after adjusting for age, sex, race, and etiology of PH (PAH vs. DHF-PH).
Conclusion: Gal-3 is a strong prognostic marker in patients with PH. Larger studies should further evaluate Gal-3’s role as a prognostic biomarker and possible therapeutic target in PH.
- © 2013 by American Heart Association, Inc.