Wang Hua, Chen Qingyong, Li Yingying, Jing Xianchao, Liang Tianya, Yang Jiefu
a Department of Cardiology , Beijing Hospital, Peking University , Beijing , China.
b Department of Cardiology , West China Hospital, Sichuan University , Chengdu , China.
Acta Cardiol. 2017 Apr;72(2):188-195. doi: 10.1080/00015385.2017.1291187.
Objective We performed a prospective observational study to explore the prognostic value of plasma galectin-3, a biomarker for fibrosis and inflammation, in Chinese patients with heart failure (HF). Methods and results Galectin-3, N-terminal pro B-type natriuretic peptide (NT-proBNP) and other clinically related variables were measured in consecutive HF patients in Beijing Hospital. Specifically, galectin-3 was detected by an enzyme-linked immunosorbent assay. The primary end point was major adverse cardiac events (MACE), including all-cause mortality or readmission at the end of follow-up. The secondary end point was all-cause mortality. The adjusted hazard ratio (HR) was determined by COX regression model. In total, 272 patients were included in this study with a median age of 77 years, of whom 55.9% were male. During a median follow-up of 584 (415-813) days, 53 patients (19.5%) died and 103 patients (37.9%) died and/or required readmission. Plasma galectin-3 levels by tertiles were associated with an increased risk for the primary end point (P < 0.001). Kaplan-Meier survival curves showed that the third tertile of galectin-3 was associated with an increased rate of MACE, compared with the first and second tertiles, with the log rank P < 0.001 and P = 0.001, respectively. In addition, the multivariate COX regression model showed that the highest tertile of galectin-3 was associated with an increased risk for MACE (HR =2.13, 95% confidence interval: 1.24-3.68, P = 0.006), compared with the lowest tertile after adjustment for age, NT-proBNP, creatinine, uric acid, albumin, haemoglobin, and estimated glomerular filtration rate (eGFR). Conclusion Plasma galectin-3 is an independent predictor of all-cause mortality and/or readmission in Chinese patients with HF.
目的 我们开展了一项前瞻性观察性研究，以探讨血浆半乳糖凝集素-3（一种纤维化和炎症的生物标志物）在中国心力衰竭（HF）患者中的预后价值。方法与结果 在北京医院对连续的HF患者测量了半乳糖凝集素-3、N末端B型利钠肽原（NT-proBNP）及其他临床相关变量。具体而言，采用酶联免疫吸附测定法检测半乳糖凝集素-3。主要终点为主要不良心脏事件（MACE），包括随访结束时的全因死亡率或再入院。次要终点为全因死亡率。采用COX回归模型确定调整后的风险比（HR）。本研究共纳入272例患者，中位年龄77岁，其中55.9%为男性。在中位随访584（415 - 813）天期间，53例患者（19.5%）死亡，103例患者（37.9%）死亡和/或需要再入院。按三分位数分组的血浆半乳糖凝集素-3水平与主要终点风险增加相关（P < 0.001）。Kaplan-Meier生存曲线显示，与第一和第二三分位数相比，半乳糖凝集素-3的第三三分位数与MACE发生率增加相关，对数秩检验P分别< 0.001和P = 0.001。此外，多变量COX回归模型显示，在调整年龄、NT-proBNP、肌酐、尿酸、白蛋白、血红蛋白和估计肾小球滤过率（eGFR）后，与最低三分位数相比，半乳糖凝集素-3的最高三分位数与MACE风险增加相关（HR = 2.13，95%置信区间：1.24 - 3.68，P = 0.006）。结论 血浆半乳糖凝集素-3是中国HF患者全因死亡率和/或再入院的独立预测因子。
