Yu Xiangdong, Sun Yuemin, Zhao Ying, Zhang Wenjuan, Yang Zhenwen, Gao Yuxia, Cai Heng, Li Yongle, Wang Qing, Bian Bo, Nie Jing
Department of Cardiology, Tianjin Medical University General Hospital.
Int Heart J. 2015 May 13;56(3):314-8. doi: 10.1536/ihj.14-304. Epub 2015 Apr 23.
In this study, we evaluated the prognostic value of plasma galectin-3 levels in patients with coronary heart disease (CHD) and chronic heart failure (HF) and selected 261 CHD patients who were consecutively admitted to our hospital. The enrolled chronic HF patients included HF patients with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF). Patients without HF served as the control group. Galectin-3 and B-type natriuretic peptide (BNP) levels were determined and the primary endpoint was the composite of all-cause mortality and rehospitalization with 12-month follow-up. Plasma galectin-3 levels were higher in HF patients compared with non-HF patients (P < 0.001). Receiver operating characteristic (ROC) analyses for diagnosis of HF showed that galectin-3 had the greatest area under the curve (AUC) of 0.756 (P < 0.001), with an optimal cutoff of 10.8 ng/mL, yielding a sensitivity of 81.7% and a specificity of 61.7%. Follow-up ROC analyses of galectin-3 for outcome prediction showed an optimal cutoff of 17.8 ng/ mL, yielding a sensitivity of 97.3% and a specificity of 77.6%. Galectin-3 yielded an AUC of 0.899 (P < 0.001), whereas the AUC of BNP was 0.633 (P = 0.022). Galectin-3 led to an AUC of 0.931 (P < 0.001) for HFpEF and an AUC of 0.882 (P < 0.001) for HFrEF. Cox proportional hazards regression analysis revealed that galectin-3 was an independent prognostic predictor for chronic HF, especially for HFpEF patients (RR: 1.231, 95% CI: 1.066-1.442). In summary, plasma galectin-3 levels were increased in CHD HF patients and were an independent predictor of all-cause mortality and rehospitalization. In HFpEF patients galectin-3 levels correlated stronger with outcomes than in HFrEF patients.
在本研究中，我们评估了血浆半乳糖凝集素-3水平在冠心病（CHD）和慢性心力衰竭（HF）患者中的预后价值，并选取了261例连续入住我院的冠心病患者。纳入的慢性HF患者包括射血分数保留的HF患者（HFpEF）和射血分数降低的HF患者（HFrEF）。无HF的患者作为对照组。测定了半乳糖凝集素-3和B型利钠肽（BNP）水平，主要终点是全因死亡率和12个月随访期间再次住院的复合终点。与非HF患者相比，HF患者的血浆半乳糖凝集素-3水平更高（P<0.001）。用于诊断HF的受试者工作特征（ROC）分析显示，半乳糖凝集素-3的曲线下面积（AUC）最大，为0.756（P<0.001），最佳截断值为10.8 ng/mL，灵敏度为81.7%，特异性为61.7%。半乳糖凝集素-3用于结局预测的随访ROC分析显示，最佳截断值为17.8 ng/mL，灵敏度为97.3%，特异性为77.6%。半乳糖凝集素-3的AUC为0.899（P<0.001），而BNP的AUC为0.633（P=0.022）。对于HFpEF，半乳糖凝集素-3的AUC为0.931（P<0.001），对于HFrEF，AUC为0.88（P<0.001）。Cox比例风险回归分析显示，半乳糖凝集素-3是慢性HF的独立预后预测因子，尤其是对于HFpEF患者（风险比：1.231，95%置信区间：1.066-1.442）。总之，CHD HF患者的血浆半乳糖凝集素-3水平升高，是全因死亡率和再次住院的独立预测因子。在HFpEF患者中，半乳糖凝集素-3水平与结局的相关性比HFrEF患者更强。
