title: Galectin-3 and the development of heart failure after acute coronary syndrome: pilot experience from PROVE IT-TIMI 22.
abstract: BACKGROUND
  Galectin-3 is a β-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 μg/L (25th, 75th percentile 14.0, 20.6) vs 14.6 μg/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.
authors: TIMI Study Group, Department of Mediicne, Brigham and Women's Hospital, Boston, MA 02115, USA. wgrandin1@partners.org
authors: E Wilson
authors: EW
authors: Grandin
authors: Petr
authors: P
authors: Jarolim
authors: Sabina A
authors: SA
authors: Murphy
authors: Lea
authors: L
authors: Ritterova
authors: Christopher P
authors: CP
authors: Cannon
authors: Eugene
authors: E
authors: Braunwald
authors: David A
authors: DA
authors: Morrow
mesh_terms: D054058:Acute Coronary Syndrome / Q000503:physiopathology*; D000368:Aged; D000069059:Atorvastatin; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D017035:Pravastatin / Q000627:therapeutic use; D011379:Prognosis; D011446:Prospective Studies; D011758:Pyrroles / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D037502:Galectin 3; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D017035:Pravastatin