Galectin-3 is independently associated with cardiovascular mortality in community-dwelling older adults without known cardiovascular disease: The Rancho Bernardo Study.
BACKGROUND
Galectin-3 is a marker of myocardial fibrosis that has been implicated in the pathophysiologic pathway of fibrosis; its association with all-cause and cardiovascular disease (CVD) mortality in a community-based cohort free of baseline CVD has not been reported. Our aim was to determine the association between galectin-3 levels and all-cause and CVD mortality in community-dwelling older adults without known CVD.


METHODS
We measured plasma galectin-3 levels in 1,393 Rancho Bernardo Study participants without CVD with a mean age of 70 years. Participants were followed up for a mean of 11 years for coronary heart disease, CVD mortality, and all-cause mortality.


RESULTS
During follow-up, 436 participants died (169 from CVD). In models adjusted for traditional CVD risk factors and renal function, galectin-3 was a significant predictor of CVD mortality (hazard ratio [HR] per SD log increase 1.30, 95% CI 1.10-1.53) and all-cause mortality (HR 1.12, 1.01-1.24), but not coronary heart disease (HR 1.09, 0.92-1.30). After further adjusting for N-terminal pro B-type natriuretic peptide, galectin-3 remained an independent predictor (HR 1.24, 1.05-1.47) of CVD mortality. Galectin-3 improved the c statistic (0.847-0.851, P = .003) for prediction of CVD death. Net reclassification improvement (>0) with the addition of galectin-3 was 35% (P < .0001); the integrated discrimination index was also significant (P = .03). Participants with both galectin-3 and N-terminal pro B-type natriuretic peptide above the median had increased risk of CVD death vs those with higher levels of only 1 of these markers (HR 1.74, 1.24-2.43).


CONCLUSIONS
Higher levels of galectin-3 are independently associated with all-cause and CVD mortality among community-dwelling older adults with no known CVD at baseline.
Division of Cardiology, Department of Medicine, University of California at San Diego, La Jolla, CA; Department of Family and Preventive Medicine, University of California at San Diego, San Diego, CA. Electronic address: lbdaniels@ucsd.edu.
Lori B
LB
Daniels
Division of Cardiology, Department of Medicine, University of California at San Diego, La Jolla, CA; Veterans Affairs San Diego Healthcare System, La Jolla, CA.
Paul
P
Clopton
Department of Family and Preventive Medicine, University of California at San Diego, San Diego, CA.
Gail A
GA
Laughlin
Division of Cardiology, Department of Medicine, University of California at San Diego, La Jolla, CA; Veterans Affairs San Diego Healthcare System, La Jolla, CA.
Alan S
AS
Maisel
Department of Family and Preventive Medicine, University of California at San Diego, San Diego, CA.
Elizabeth
E
Barrett-Connor
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002140:California / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D037502:Galectin 3 / Q000097:blood*; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
D015415:Biomarkers; D037502:Galectin 3