title: Utility of galectin-3 as a prognostic biomarker in heart failure: where do we stand?
abstract: BACKGROUND
  Heart failure (HF) continues to be an illness of daunting proportions with a four- year mortality touching 50%. Biomarkers for prognosticating patients with heart failure have generated immense interest. Several studies have been conducted on a novel biomarker, galectin-3 to assess its prognostic effect in heart failure populations. However, the studies have generated conflicting results. Hence a systematic review was done to assess the utility of galectin-3 as a prognostic biomarker in HF.
  
  
  METHODS
  This study was a systematic review.
  
  
  METHODS
  A literature search was done using terms 'galectin-3 and heart' and 'galectin-3 and heart failure' in MEDLINE, Science Direct, Scopus, Springer Link, Cochrane Library and Google Scholar for original articles using a predefined inclusion/exclusion criteria.
  
  
  RESULTS
  Altogether 27 original articles were selected for the systematic review. Multivariate analysis showed galectin-3 to be ineffective in predicting all-cause mortality and cardiovascular mortality especially under the influence of factors such as estimated glomerular filtration rate (eGFR), left ventricular ejection fraction (LVEF) and N-terminal pro-B-type natriuretic peptide (NTproBNP). Galectin-3 was not found to be superior to NTproBNP, sST2, GDF-15 or C-reactive protein (CRP) as a predictor of mortality. However the combination of natriuretic peptides and galectin-3 has been observed to be superior in predicting mortality compared to either of the biomarkers alone. The role of galectin-3 in remodelling has not been conclusively proven as seen in earlier pre-clinical studies.
  
  
  CONCLUSIONS
  The current weight of evidence does not suggest galectin-3 to be a predictor of mortality. However, assessment of galectin-3 in a multi-biomarker panel may have a distinct advantage in prognosticating patients with heart failure.
authors.affiliation: Department of Cardiology, SRM Medical College Hospital and Research Centre, India.
authors.forename: Varsha
authors.initials: V
authors.lastname: Srivatsan
authors.affiliation: Department of Cardiology, SRM Medical College Hospital and Research Centre, India melvingeorge2003@gmail.com.
authors.forename: Melvin
authors.initials: M
authors.lastname: George
authors.affiliation: Department of Cardiology, SRM Medical College Hospital and Research Centre, India.
authors.forename: Elangovan
authors.initials: E
authors.lastname: Shanmugam
mesh_terms: D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins; D002423:Cause of Death; D015897:Comorbidity; D018450:Disease Progression; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human
keywords: Galectin-3; N-terminal pro-B-type natriuretic peptide; cardiovascular mortality; heart failure; left ventricular remodelling; mortality