Gagno Giulia, Padoan Laura, Stenner Elisabetta, Beleù Alessandro, Ziberna Fabiana, Hiche Cristina, Paldino Alessia, Barbati Giulia, Biolo Gianni, Fiotti Nicola, Not Tarcisio, Beltrami Antonio Paolo, Sinagra Gianfranco, Aleksova Aneta
Cardiovascular Department, Azienda Sanitaria Universitaria di Trieste and Department of Medical Surgical and Health Sciences, University of Trieste, 34129 Trieste, Italy.
Sport and Exercise Medicine Division, Department of Medicine, University of Padova, 35122 Padova, Italy.
J Clin Med. 2019 Apr 26;8(5):570. doi: 10.3390/jcm8050570.
Acute myocardial infarction (AMI) survivors are at risk of major adverse cardiac events and their risk stratification is a prerequisite to tailored therapeutic approaches. Biomarkers could be of great utility in this setting.
We sought to evaluate the utility of the combined assessment of Galectin 3 (Gal-3) and Galectin 3 binding protein (Gal-3bp) for post-AMI risk stratification in a large, consecutive population of AMI patients. The primary outcomes were: Recurrent angina/AMI and all-cause mortality at 12 months after the index event.
In total, 469 patients were included. The median Gal-3bp was 9.1 μg/mL (IQR 5.8-13.5 μg/mL), while median Gal-3 was 9.8 ng/mL (IQR 7.8-12.8 ng/mL). During the 12 month follow-up, 34 patients died and 41 had angina pectoris/reinfarction. Gal-3 was associated with all-cause mortality, while Gal-3bp correlated with the risk of angina/myocardial infarction even when corrected for other significant covariates. The final multivariable model for mortality prediction included patients' age, left ventricular ejection fraction (LVEF), Gal-3, and renal function. The ROC curve estimated for this model has an area under the curve (AUC) of 0.84 (95%CI 0.78-0.9), which was similar to the area under the ROC curve obtained using the GRACE score 1-year mortality.
The integrated assessment of Gal-3 and Gal-3bp could be helpful in risk stratification after AMI.
急性心肌梗死（AMI）幸存者有发生重大不良心脏事件的风险，对其进行风险分层是采取针对性治疗方法的前提。生物标志物在这种情况下可能非常有用。
我们试图评估在一大群连续的AMI患者中，联合评估半乳糖凝集素3（Gal-3）和半乳糖凝集素3结合蛋白（Gal-3bp）对AMI后风险分层的作用。主要结局为：在索引事件发生后12个月时复发性心绞痛/AMI和全因死亡率。
总共纳入了469例患者。Gal-3bp的中位数为9.1μg/mL（四分位间距5.8 - 13.5μg/mL），而Gal-3的中位数为9.8ng/mL（四分位间距7.8 - 12.8ng/mL）。在12个月的随访期间，34例患者死亡，41例发生心绞痛/再梗死。Gal-3与全因死亡率相关，而Gal-3bp即使在校正其他显著协变量后仍与心绞痛/心肌梗死风险相关。用于死亡率预测的最终多变量模型包括患者年龄、左心室射血分数（LVEF）、Gal-3和肾功能。该模型估计的ROC曲线下面积（AUC）为0.84（95%CI 0.78 - 0.9），这与使用GRACE评分1年死亡率获得的ROC曲线下面积相似。
Gal-3和Gal-3bp的综合评估可能有助于AMI后的风险分层。
