Galectin-3 and the Development of Heart Failure after Acute Coronary Syndrome: Pilot Experience from PROVE IT-TIMI 22

被引:103
作者
Grandin, E. Wilson [1 ]
Jarolim, Petr [3 ]
Murphy, Sabina A.
Ritterova, Lea [3 ]
Cannon, Christopher P. [2 ]
Braunwald, Eugene [2 ]
Morrow, David A. [2 ]
机构
[1] Brigham & Womens Hosp, Dept Med, TIMI Study Grp, Boston, MA 02115 USA
[2] Brigham & Womens Hosp, Dept Med, Cardiovasc Div, Boston, MA 02115 USA
[3] Brigham & Womens Hosp, Dept Pathol, Boston, MA 02115 USA
关键词
MYOCARDIAL-INFARCTION; PROGNOSTIC VALUE; MACROPHAGES; PREDICTORS; EXPRESSION;
D O I
10.1373/clinchem.2011.174359
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
BACKGROUND: Galectin-3 is a beta-galactoside-binding lectin that has been implicated in cardiac fibrosis and remodeling, is increased in models of failure-prone hearts, and has prognostic value in patients with heart failure (HF). The relationship between galectin-3 and the development of HF after acute coronary syndrome (ACS) is unknown. METHODS: In a nested case-control study among patients with ACS in PROVE IT-TIMI 22, we identified 100 cases with a hospitalization for new or worsening HF. Controls were matched (1:1) for age, sex, ACS type, and randomized treatment. Serum galectin-3 was measured at baseline (within 7 days post-ACS). RESULTS: Patients who developed HF had higher baseline galectin-3 [median 16.7 mu g/L (25th, 75th percentile 14.0, 20.6) vs 14.6 mu g/L (12.0, 17.6), P = 0.004]. Patients with baseline galectin-3 above the median had an odds ratio of 2.1 (95% CI 1.2-3.6) for developing HF, P = 0.010. Galectin-3 showed a graded relationship with risk of HF. Cases were more likely to have hypertension, diabetes, prior MI, and prior HF; after adjustment for these factors, this graded relationship with galectin-3 quartile and HF remained significant [adjusted OR 1.4 (95% CI 1.1-1.9), P = 0.020]. When BNP was added to the model, the relationship between galectin-3 and HF was attenuated [adjusted OR 1.3 (95% CI: 0.96 -1.9), P = 0.08]. CONCLUSIONS: The finding that galectin-3 is associated with the risk of developing HF following ACS adds to emerging evidence supporting galectin-3 as a biomarker of adverse remodeling contributing to HF as well as a potential therapeutic target. (C) 2011 American Association for Clinical Chemistry
引用
收藏
页码:267 / 273
页数:7
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