Stanford University School of Medicine, Stanford, California, USA.
Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
Curr Cardiol Rev. 2023;19(3):e171122211004. doi: 10.2174/1573403X19666221117122012.
Heart failure (HF) is a leading cause of death worldwide. The global prevalence of heart failure is projected to increase rapidly in the coming decades, and significant attention has turned to improving biomarker-based risk prediction of incident HF. This paper aimed to qualitatively and quantitatively evaluate the evidence associating levels of galectin-3 with the risk of incident HF.
A review of PUBMED-indexed peer-reviewed literature was performed. Nine studies met the inclusion criteria, and all nine had data eligible for conversion and pooling. A randomeffects meta-analysis was performed using hazard ratios and 95% confidence intervals from a minimally adjusted model, a further adjusted model, and from subgroups within the further-adjusted model.
The minimally-adjusted model provided an HR of 1.97 (95% CI 1.74-2.23) when comparing the top quartile of log-gal-3 to the bottom quartile. The further-adjusted model provided an HR of 1.32 (95% CI 1.21-1.44) for the same comparison. The positive, significant association was conserved during sensitivity analysis.
There is a significant positive association between circulating galectin-3 and the risk of incident heart failure. Given the complex mechanistic relationship between galectin-3 and cardiovascular pathophysiology, further investigation is recommended for the possible implementation of galectin-3 into clinical risk prediction models.
心力衰竭(HF)是全球范围内主要的致死原因。在未来几十年中,全球心力衰竭的患病率预计将迅速增加,因此人们高度关注如何改善基于生物标志物的心力衰竭事件风险预测。本文旨在定性和定量评估半乳糖凝集素-3(galectin-3)水平与心力衰竭事件风险之间的关联证据。
对 PUBMED 索引的同行评议文献进行了综述。符合纳入标准的有 9 项研究,所有 9 项研究均有符合纳入标准的数据。采用最小调整模型、进一步调整模型和进一步调整模型中的亚组的风险比和 95%置信区间进行随机效应荟萃分析。
最小调整模型比较 log-gal-3 的最高四分位数与最低四分位数时,提供了 1.97(95%CI 1.74-2.23)的 HR。同样的比较中,进一步调整模型提供了 1.32(95%CI 1.21-1.44)的 HR。敏感性分析中保留了这种阳性、显著的关联。
循环半乳糖凝集素-3与心力衰竭事件风险之间存在显著的正相关关系。鉴于半乳糖凝集素-3与心血管病理生理学之间复杂的机制关系,建议进一步研究将半乳糖凝集素-3纳入临床风险预测模型的可能性。