Grande Dario, Leone Marta, Rizzo Caterina, Terlizzese Paola, Parisi Giuseppe, Gioia Margherita Ilaria, Leopizzi Tiziana, Segreto Antonio, Guida Piero, Romito Roberta, Ciccone Marco Matteo, Serio Francesca Di, Iacoviello Massimo
School of Cardiology, University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy.
Cardiology Unit, S.S. Annunziata Hospital, Via Bruno Francesco 1, 74123 Taranto, Italy.
J Cardiovasc Dev Dis. 2017 Jul 15;4(3):9. doi: 10.3390/jcdd4030009.
Galectin-3 and ST2 are emerging biomarkers involved in myocardial fibrosis. We evaluate the relevance of a multiparametric biomarker approach based on increased serum levels of NT-proBNP, galectin-3, and ST2 in stratifying the prognosis of chronic heart failure (CHF) outpatients. In 315 CHF outpatients in stable clinical condition clinical and echocardiographic evaluations were performed. Routine chemistry and serum levels of NT-proBNP, galectin-3, and ST2 were also assessed. During a 12 month follow-up, cardiovascular death, and/or heart failure (HF) occurred in 64 patients. The presence of NT-proBNP, galectin-3, and ST2 were higher than the recommended cutoffs and were all associated with events at univariate Cox regression analysis, as well as in a multivariate analysis including the three biomarkers. When a score based on the number of biomarkers above the recommended cut-offs was used (in a range of 0-3), it was associated with events both with respect to the univariate (HR 2.96, 95% CI 2.21-3.95, 0.001, C-index 0.78) and the multivariate (HR 1.52, 95% CI 1.06-2.17, 0.023, C-index 0.87) analyses, after correction for the variables of a reference model. Our results suggest that an easy prognostic approach based on the combination of three biomarkers, although with partially-overlapping pathophysiological mechanisms, is able to identify patients with the highest risk of heart failure progression.
半乳糖凝集素-3和ST2是参与心肌纤维化的新兴生物标志物。我们评估了基于血清NT-proBNP、半乳糖凝集素-3和ST2水平升高的多参数生物标志物方法在慢性心力衰竭（CHF）门诊患者预后分层中的相关性。对315例临床病情稳定的CHF门诊患者进行了临床和超声心动图评估。还评估了常规生化指标以及NT-proBNP、半乳糖凝集素-3和ST2的血清水平。在12个月的随访期间，64例患者发生了心血管死亡和/或心力衰竭（HF）。NT-proBNP、半乳糖凝集素-3和ST2的水平高于推荐的临界值，在单变量Cox回归分析以及包括这三种生物标志物的多变量分析中均与事件相关。当使用基于高于推荐临界值的生物标志物数量的评分（范围为0-3）时，在校正参考模型的变量后，单变量分析（HR 2.96，95%CI 2.21-3.95，P<0.001，C指数0.78）和多变量分析（HR 1.52，95%CI 1.06-2.17，P=0.023，C指数0.87）均显示其与事件相关。我们的结果表明，基于三种生物标志物组合的简单预后方法，尽管其病理生理机制部分重叠，但能够识别心力衰竭进展风险最高的患者。
