Author + information
- Received September 6, 2018
- Revision received February 1, 2019
- Accepted February 4, 2019
- Published online May 6, 2019.
- Rabea Asleh, MD, PhD, MHAa,
- Maurice Enriquez-Sarano, MDa,
- Allan S. Jaffe, MDa,
- Sheila M. Manemann, MPHb,
- Susan A. Weston, MSb,
- Ruoxiang Jiang, BSb and
- Véronique L. Roger, MD, MPHa,b,∗ ()
- aDepartment of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
- bDepartment of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
- ↵∗Address for correspondence:
Dr. Véronique L. Roger, Department of Cardiovascular Diseases and Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905.
Background Galectin-3 (Gal-3) is implicated in cardiac fibrosis, but its association with adverse outcomes after myocardial infarction (MI) is unknown.
Objectives The purpose of this study was to examine the prognostic value of Gal-3 in a community cohort of incident MI.
Methods A population-based incidence MI cohort was prospectively assembled in Olmsted County, Minnesota, between 2002 and 2012. Gal-3 levels were measured at the time of MI. Patients were followed for heart failure (HF) and death.
Results A total of 1,342 patients were enrolled (mean age 67.1 years; 61.3% male; 78.8% non–ST-segment elevation MI). Patients with elevated Gal-3 were older and had more comorbidities. Over a mean follow-up of 5.4 years, 484 patients (36.1%) died and 368 (27.4%) developed HF. After adjustment for age, sex, comorbidities, and troponin, patients with Gal-3 values in tertiles 2 and 3 had a 1.3-fold (95% confidence interval [CI]: 0.9-fold to 1.7-fold) and a 2.4-fold (95% CI: 1.8-fold to 3.2-fold) increased risk of death, respectively (ptrend < 0.001) compared with patients with Gal-3 values in tertile 1. Patients with Gal-3 values in tertiles 2 and 3 had a higher risk of HF with hazard ratios of 1.4 (95% CI: 1.0 to 2.0) and 2.3 (95% CI: 1.6 to 3.2), respectively (ptrend < 0.001). With further adjustment for soluble suppression of tumorigenicity-2, elevated Gal-3 remained associated with increased risk of death and HF. The increased risk of HF did not differ by HF type and was independent of the occurrence of recurrent MI.
Conclusions Gal-3 is an independent predictor of mortality and HF post-MI. These findings suggest a role for measuring Gal-3 levels for risk stratification post-MI.
This work was supported by a grant from the National Heart, Lung, and Blood Institute (R01-HL120957) and the Rochester Epidemiology Project (R01-AG034676). The funding sources played no role in the design, conduct, or reporting of this study. Dr. Jaffe has served as a consultant for Beckman, Coulter, Siemens, Abbott, ET Healthcare, Quidel, Roche, Alere, NeurogenomeX, Sphingotec, Single, and Novartis. Dr. Roger has received grants from the National Heart, Lung, and Blood Institute (RO1 HL 120959) and Patient Centered Outcomes Research Institute (PCORI) CDRN-1501-26638-1 during the conduct of the study; and has served as a consultant for Sanofi. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received September 6, 2018.
- Revision received February 1, 2019.
- Accepted February 4, 2019.
- 2019 American College of Cardiology Foundation
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