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基于人群的1997年芬兰危险因素干预研究(FINRISK)队列中,半乳糖凝集素-3对新发心血管疾病和心力衰竭的预测价值。

Predictive value of galectin-3 for incident cardiovascular disease and heart failure in the population-based FINRISK 1997 cohort.

作者信息

Jagodzinski Annika, Havulinna Aki S, Appelbaum Sebastian, Zeller Tanja, Jousilahti Pekka, Skytte-Johanssen Silke, Hughes Maria F, Blankenberg Stefan, Salomaa Veikko

机构信息

Department of General and Interventional Cardiology, Hamburg University Heart Centre, Hamburg, Germany; Deutsches Zentrum für Herzkreislaufforschung (DZHK e.V.); Partner site Hamburg, Lübeck, Kiel, Germany.

National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland.

出版信息

Int J Cardiol. 2015 Aug 1;192:33-9. doi: 10.1016/j.ijcard.2015.05.040. Epub 2015 May 9.

Abstract

OBJECTIVES

Galectin-3 is an emerging biomarker playing an important, complex role in intracellular pathways of cardiovascular diseases and heart failure. We aimed therefore to investigate the predictive value of galectin-3 for incident cardiovascular disease and heart failure.

METHODS

Galectin-3 levels were measured in 8444 participants of the general population-based FINRISK 1997 cohort. Cox proportional hazards regression analyses, adjusting for traditional Framingham risk factors, prevalent valvular heart disease, eGFR (estimated glomerular filtration rate) as well as NT-proBNP, were used to examine the predictive power of galectin-3. Measurements of discrimination and reclassification using 10-fold cross-validation were performed to control for over-optimism. Cardiovascular death (CD), all-cause mortality, myocardial infarction (MI), ischemic stroke (hemorrhagic strokes were excluded) and heart failure (HF) were used as endpoints.

RESULTS

During the follow-up of up to 15 years there were in total 1136 deaths from any cause, 383 cardiac deaths, 359 myocardial infarctions, 401 ischemic strokes and 641 cases of incident heart failure. Hazard ratios (HR) were statistically significant for all-cause mortality (1.12, p < 0.001), cardiac death (1.15, p = 0.033) and heart failure (1.10, p = 0.049). Statistical significance was lost when analyzing by gender except for all-cause mortality. No significant improvements were observed in model discrimination or overall reclassification upon inclusion of galectin-3. Compared to NT-proBNP, the predictive power of galectin-3 was weaker but both remained significant, independently of each other.

CONCLUSION

Galectin-3 levels were predictive for future cardiovascular events but improvements in discrimination and reclassifications were modest.

摘要

目的

半乳糖凝集素-3是一种新兴的生物标志物,在心血管疾病和心力衰竭的细胞内信号通路中发挥着重要而复杂的作用。因此,我们旨在研究半乳糖凝集素-3对心血管疾病和心力衰竭发病的预测价值。

方法

在基于芬兰全国FINRISK 1997队列研究的8444名普通人群参与者中测量了半乳糖凝集素-3水平。采用Cox比例风险回归分析,对传统的弗雷明汉姆风险因素、瓣膜性心脏病、估算肾小球滤过率(eGFR)以及N末端脑钠肽前体(NT-proBNP)进行校正,以检验半乳糖凝集素-3的预测能力。使用10倍交叉验证进行鉴别和重新分类测量,以控制过度乐观的情况。以心血管死亡(CD)、全因死亡率、心肌梗死(MI)、缺血性卒中(排除出血性卒中)和心力衰竭(HF)作为终点。

结果

在长达15年的随访期间,共有1136例全因死亡、383例心源性死亡、359例心肌梗死、401例缺血性卒中和641例新发心力衰竭病例。全因死亡率(1.12,p<0.001)、心源性死亡(1.15,p=0.033)和心力衰竭(1.10,p=0.049)的风险比(HR)具有统计学意义。按性别分析时,除全因死亡率外,均无统计学意义。纳入半乳糖凝集素-3后,模型鉴别或总体重新分类未观察到显著改善。与NT-proBNP相比,半乳糖凝集素-3的预测能力较弱,但两者均保持显著,且相互独立。

结论

半乳糖凝集素-3水平可预测未来心血管事件,但鉴别和重新分类的改善程度较小。

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