title: Predictive value of serum galectin-3 levels in patients with acute heart failure with preserved ejection fraction.
abstract: OBJECTIVE
  This study was conducted to determine whether galectin-3 (Gal3), a β-galactoside-binding lectin, has usefulness to predict outcomes in patients with heart failure (HF) and preserved left ventricular ejection fraction (LVEF).
  
  
  RESULTS
  We measured Gal3, urea, creatinine and natriuretic peptides on admission in 419 selected patients with HF and LVEF over 45%. The primary endpoint was all-cause mortality and/or readmission at one-year follow-up. Multivariable Cox proportional hazards models were generated for Gal3 and classical risk factors. We also evaluated the reclassification of patients on the basis of the different score category after adding Gal3 levels. A total of 219 patients had combined adverse events, and 129 patients died during the follow-up. Kaplan-Meir survival curve showed significantly increased primary endpoint and all-cause mortality according to quartiles of Gal3 (log rank, P<0.001). Serum Gal3 levels above median (13.8 ng/ml) was a significant predictor of primary endpoint risk after adjustment for age, estimated glomerular filtration rate, anemia, diabetes, serum sodium, brain natriuretic peptide levels, NYHA class and urea, respectively (hazard ratio 1.43, 95% CI 1.07-1.91 P=0.015). The reclassification index increased significantly after addition of Gal3 (9.5%, P<0.001) and the integrated discrimination index was 0.022, (P=0.001). The clinical prediction model with Gal3 increased the c-statistic from 0.711 to 0.731 (difference of 0.020, P=0.001).
  
  
  CONCLUSIONS
  Serum Gal3 is a strong and independent predictor of unfavorable outcomes in patients with HF and preserved LVEF. We also demonstrated the improvement of adding the new biomarker to the model.
authors.affiliation: Department of Internal Medicine, Hospital Juan Ramón Jiménez, Huelva, Spain. Electronic address: fjcarrascos@telefonica.net.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Carrasco-Sánchez
authors.forename: Oscar
authors.initials: O
authors.lastname: Aramburu-Bodas
authors.forename: Prado
authors.initials: P
authors.lastname: Salamanca-Bautista
authors.forename: José Luis
authors.initials: JL
authors.lastname: Morales-Rull
authors.forename: Luis
authors.initials: L
authors.lastname: Galisteo-Almeda
authors.forename: María Inmaculada
authors.initials: MI
authors.lastname: Páez-Rubio
authors.forename: José Luis
authors.initials: JL
authors.lastname: Arias-Jiménez
authors.forename: Mariano
authors.initials: M
authors.lastname: Aguayo-Canela
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Pérez-Calvo
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins; D005260:Female; D005500:Follow-Up Studies; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology*
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human
keywords: Galectin-3; Heart failure; Preserved ejection fraction; Prognosis; Reclassification