State Key Laboratory of Cardiovascular Disease, Heart Failure Center Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
State Key Laboratory of Cardiovascular Disease, Heart Failure Center Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Card Fail. 2015 Jan;21(1):51-9. doi: 10.1016/j.cardfail.2014.10.006. Epub 2014 Oct 16.
Galectin-3 has been shown to be involved in the process of cardiac fibrosis and to predict adverse events in heart failure (HF), but the association of galectin-3 with cause-specific death has not been well established. The purpose of this study was to investigate the prognostic value of baseline galectin-3 for all-cause, cardiovascular (CV), and in-hospital death in patients with HF.
From March 2009 to April 2013, we consecutively measured galectin-3 in a large cohort of 1,440 hospitalized patients with HF. Cox proportional hazards regression, discrimination, and reclassification analyses were used to evaluate the association between galectin-3 and death. During a median follow-up of 582 days, 283 deaths were identified, of which 64 were patients who died during hospitalization. Compared with the lowest galectin-3 tertile, the highest 2 tertiles were significantly associated with all-cause, CV, and progressive HF death, but not significant for sudden and in-hospital death when analyzed by multivariable Cox regression. The utility of combining galectin-3 and N-terminal pro-B-type natriuretic peptide was assessed by dichotomizing these 2 biomarkers according to their median values. The highest risk of death due to all-cause, CV, and progressive HF was observed when both biomarkers were elevated after adjustment for established risk factors. Addition of galectin-3 to the prediction model for all-cause and CV death significantly improved discrimination and reclassification.
Galectin-3 independently predicted death and added additional prognostic value beyond established risk factors in hospitalized patients with HF. The utility of galectin-3 alone as a risk predictor was not strong enough to assess sudden or in-hospital death.
半乳糖凝集素-3 已被证明参与了心肌纤维化过程，并可预测心力衰竭（HF）的不良事件，但半乳糖凝集素-3 与特定原因死亡的关系尚未得到很好的确定。本研究旨在探讨基线半乳糖凝集素-3 对 HF 患者全因、心血管（CV）和住院内死亡的预后价值。
2009 年 3 月至 2013 年 4 月，我们连续测量了 1440 例住院 HF 患者的大量队列中的半乳糖凝集素-3。使用 Cox 比例风险回归、区分和再分类分析来评估半乳糖凝集素-3 与死亡之间的关系。在中位数为 582 天的随访期间，确定了 283 例死亡，其中 64 例为住院期间死亡的患者。与最低三分位的半乳糖凝集素-3 相比，最高的 2 个三分位与全因、CV 和进行性 HF 死亡显著相关，但多变量 Cox 回归分析时，与猝死和住院内死亡无显著相关性。根据中位数将半乳糖凝集素-3 和 N-末端 pro-B 型利钠肽这 2 种生物标志物进行二分法，评估联合使用这 2 种标志物的效果。调整既定危险因素后，当这 2 种标志物均升高时，全因、CV 和进行性 HF 死亡的风险最高。在全因和 CV 死亡的预测模型中加入半乳糖凝集素-3 可显著提高区分度和再分类。
半乳糖凝集素-3 可独立预测死亡，并在住院 HF 患者中提供超出既定危险因素的额外预后价值。半乳糖凝集素-3 作为风险预测因子的单独使用不足以评估猝死或住院内死亡。
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