Galectin 3 is a powerful risk predictor for recurrent coronary events in acute coronary syndrome patients

• Background: Galectin 3 and ST2 are mediators and biomarkers of myocardial fibrosis and remodeling that have recently entered the clinical practice guidelines as prognostic factors in heart failure patients. Elevated galectin 3 and ST2 levels in acute myocardial infarction patients have also been associated with increased incidence of adverse events during follow-up. Purpose: We aimed to assess the comparative ability of Galectin 3 and ST2 to offer additional prognostic information for risk stratification in acute coronary syndrome (ACS) patients, on top of traditional cardiovascular risk factors and other established prognostic biomarkers. Methods: We measured the levels of galectin 3, ST2, N-terminal pro-B type natriuretic peptide (NTproBNP), high-sensitivity C-reactive protein (hsCRP), highsensitivity troponin T (TnT), cystatin C, and lipids in plasma collected from 524 ACS patients (STEMI, non-STEMI and unstable angina) on day 1 following the acute event. Biomarker levels were correlated with the risk to develop recurrent coronary events, in linear regression models adjusted for age, sex and traditional risk factors (smoking, diabetes mellitus, hypertension, LDL, HDL and triglycerides). Results: During a mean follow-up period of 2.13 years, 63 (12%) of the patients suffered a new coronary event. Baseline galectin 3, ST2, hsCRP, NTproBNP and cystatin C were significantly higher in these patients compared to the event-free controls. In a Cox proportional hazards model with forward step selection that included all biomarkers alongside traditional risk factors, age (HR per year of age 1.06, 95% CI 1.03-1.09), galectin 3 (HR per SD log increase 1.88, 95% CI 1.41- 2.51) and cystatin C (HR per SD log increase 1.39, 95% CI 1.12-1.74) were selected as the only independent predictors of recurrent events in the population. In receiver operating curve (ROC) analyses, addition of galectin 3 significantly improved the c-statistic of the model based on traditional risk factors alone (0.81 vs. 0.76, P

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

galectin 3

biological marker

cystatin C

triacylglycerol

amino terminal pro brain natriuretic peptide

troponin T

C reactive protein

lipid

high density lipoprotein

low density lipoprotein

risk

acute coronary syndrome

patient

human

European

society

cardiology

model

risk factor

follow up

cardiovascular risk

practice guideline

hypertension

diabetes mellitus

event free survival

smoking

linear regression analysis

stratification

heart muscle fibrosis

unstable angina pectoris

non ST segment elevation myocardial infarction

acute heart infarction

plasma

heart failure

population

proportional hazards model

prediction

ST segment elevation myocardial infarction

Publikations- och innehållstyp

kon (ämneskategori)

ref (ämneskategori)