Galectin-3 Levels and Outcomes After Myocardial Infarction

A Population-Based Study

Rabea Asleh, Maurice E Sarano, Allan S Jaffe, Sheila M. Manemann, Susan A. Weston, Ruoxiang Jiang, Veronique Lee Roger

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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 (p trend < 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 (p trend < 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.

Original languageEnglish (US)
Pages (from-to)2286-2295
Number of pages10
JournalJournal of the American College of Cardiology
Volume73
Issue number18
DOIs
StatePublished - May 14 2019

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Galectin 3
Myocardial Infarction
Heart Failure
Population
Confidence Intervals
Comorbidity
Troponin
Fibrosis

Keywords

  • biomarkers
  • galectin-3
  • heart failure
  • mortality
  • myocardial infarction
  • population-based study

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Galectin-3 Levels and Outcomes After Myocardial Infarction : A Population-Based Study. / Asleh, Rabea; Sarano, Maurice E; Jaffe, Allan S; Manemann, Sheila M.; Weston, Susan A.; Jiang, Ruoxiang; Roger, Veronique Lee.

In: Journal of the American College of Cardiology, Vol. 73, No. 18, 14.05.2019, p. 2286-2295.

Research output: Contribution to journalArticle

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title = "Galectin-3 Levels and Outcomes After Myocardial Infarction: A Population-Based Study",
abstract = "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 (p trend < 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 (p trend < 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.",
keywords = "biomarkers, galectin-3, heart failure, mortality, myocardial infarction, population-based study",
author = "Rabea Asleh and Sarano, {Maurice E} and Jaffe, {Allan S} and Manemann, {Sheila M.} and Weston, {Susan A.} and Ruoxiang Jiang and Roger, {Veronique Lee}",
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T1 - Galectin-3 Levels and Outcomes After Myocardial Infarction

T2 - A Population-Based Study

AU - Asleh, Rabea

AU - Sarano, Maurice E

AU - Jaffe, Allan S

AU - Manemann, Sheila M.

AU - Weston, Susan A.

AU - Jiang, Ruoxiang

AU - Roger, Veronique Lee

PY - 2019/5/14

Y1 - 2019/5/14

N2 - 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 (p trend < 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 (p trend < 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.

AB - 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 (p trend < 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 (p trend < 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.

KW - biomarkers

KW - galectin-3

KW - heart failure

KW - mortality

KW - myocardial infarction

KW - population-based study

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