The GALA study: relationship between galectin-3 serum levels and short- and long-term outcomes of patients with acute heart failure. (17th November 2017)

• Record Type: Journal Article
• Authors: Miró, Òscar; González de la Presa, Bernardino; Herrero-Puente, Pablo; Fernández Bonifacio, Rosa; Möckel, Martin; Mueller, Christian; Casals, Gregori; Sandalinas, Silvia; Llorens, Pere; Martín-Sánchez, Francisco Javier; Jacob, Javier; Bedini, José Luis; Gil, Víctor
• Is Part Of: Biomarkers. Volume 22:Number 8(2017)
• Page Start: 731
• Page End: 739
• Publication Date: 2017-11-17
• Subjects: Galectin-3 -- biomarker -- acute heart failure -- mortality -- rehospitalization -- ED revisit; Biochemical markers -- Periodicals; 610.28
• DOI: 10.1080/1354750X.2017.1319421
• Languages: English
• ISSNs: 1354-750X

Abstract

Abstract: Objective: We tested the hypothesis that early measurement of galectin-3 at the emergency department (ED) during an episode of acute heart failure (AHF) allows predicting short- and long-term outcomes. Methods: We performed an exploratory study including 115 patients consecutively diagnosed with AHF in a single ED. Clinical and analytical variables were recorded. The primary endpoint was 30-day all-cause mortality, and secondary endpoints were 30-day composite outcome (death, rehospitalization or ED reconsultation, whichever first) and 1-year mortality. Results: Seven patients (6.1%) died within 30 days and 43 (37.4%) within 1 year. The 30-day composite endpoint was observed in 21.1% of patients. Galectin-3 was correlated with NT-proBNP and the glomerular filtration rate but not with age and s-cTnI. Measured at time of ED arrival, galectin-3 showed good discriminatory capacity for 30-day mortality (AUC ROC: 0.732; 95% CI 0.512–0.953; p = 0.041) but not for 1-year mortality (0.521; 0.408–0.633; p = 0.722). Patients with galectin-3 concentrations >42 μg/L had an OR = 7.67(95%CI = 1.57-37.53; p = 0.012) for 30-day mortality. Conversely, NT-proBNP only showed predictive capacity for 1-year mortality (0.642; 0.537–0.748; p = 0.014). Patients with NT-proBNP concentrations >5400 ng/L had an OR = 4.34 (95%CI = 1.93-9.77; p < 0.001) for 1-year mortality. These increased short- (galectin-3) and long-term (NT-proBNP) risks remained significant after adjustment for age or renal function. s-cTnI failed in both short- and long term death prediction. No biomarker predicted the short-term composite endpoint. Conclusion: These results suggest that galectin-3 could help to monitor the risk of short-term mortality in unselected patients with AHF attended in the ED.