Galectin-3 Associated with Poor Prognosis in Cardiopathy Patients

The soluble β-galactoside-binding lectin, galectin-3, is elevated in a substantial portion of patients with heart failure, especially those with more severe disease and renal dysfunction.

Increased levels of circulating galectin-3 may reflect the severity of active myocardial remodeling and adverse outcome as galectin-3 regulates fibrogenesis, inflammation, tissue repair, and cell proliferation.

Scientists and cardiologists at the Veterans Administration Medical Center (Minneapolis, MN, USA) conducted a randomized, placebo-controlled, double-blind, multicenter trial that enrolled 5,010 patients with symptomatic heart failure (HF) to evaluate the efficacy of the angiotensin receptor blocker (ARB) valsartan. They measured galectin-3 and other biomarkers such as high-sensitivity C-reactive protein, high-sensitivity troponin, and B-type natriuretic peptide at three time points in a subpopulation of the trial patients. The time points were at baseline at 4 and 12 months after randomization.

Plasma samples from the patients were analyzed and galectin-3 was measured using an enzyme-linked immunosorbent assay (ELISA) (BG Medicine Inc.; Waltham, MA, USA). Galectin-3 levels at baseline ranged from 4.8 to 53 ng/mL. The median baseline galectin-3 level in 1,650 patients was 16.2 ng/mL, and levels increased significantly from baseline. At 4 months, the level increased by 1.0 ng/mL and by 12 months it had risen by 2.2 ng/mL. Each 1 ng/mL increase in galectin-3 was associated with an estimated 2.9% higher risk of mortality, 2.1% increased risk of first morbid event, and 2.2% greater risk of heart failure hospitalization.

The authors concluded that galectin-3 levels are elevated in a substantial proportion of patients with HF, particularly those with more severe HF and renal impairment. Median galectin-3 levels increased over time, and the magnitude of these serial increases was found to be independently and significantly associated with poorer HF outcomes. In patients with baseline galectin-3 levels below the median, use of valsartan was associated with a significant decrease in hospitalizations for heart failure. The study was published in the May 2013 issue of the European Journal of Heart Failure.

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Veterans Administration Medical Center
BG Medicine Inc.