title: Galectin-3 predicts short- and long-term outcome in patients undergoing transcatheter aortic valve implantation (TAVI).
abstract: Until now, no reliable biomarker has become available for short- or long-term outcome prediction in patients undergoing transcatheter aortic valve implantation (TAVI). Our goal was to investigate whether galectin-3 is also suited for risk assessment in TAVI patients. Galectin-3, a novel marker indicative for myocardial fibrosis, has prognostic value in heart failure. We included 101 patients undergoing TAVI in this prospective, single-center, observational study. Baseline galectin-3 levels were correlated to the VARC 30-day safety and one-year efficacy endpoint as well as to total mortality and cardiovascular events at one year. At baseline, mean galectin-3 level for the entire group was 18.1 (± 11.1) ng/ml. Of the 101 patients, 36 had a galectin-3 value above the cut off value of 17.8 ng/ml. These patients had significantly higher systolic pulmonary artery and capillary wedge pressures. The hazard ratio in patients with galectin-3 > 17.8 ng/ml was 3.36 (95% confidence interval, CI: 1.47-7.69; p=0.004) for the VARC 30-day safety endpoint, 5.12 (95% CI: 2.10-12.47; p<0.001) for one-year cardiovascular events, and 4.48 (95% CI: 1.56-12.91; p=0.005) for all-cause mortality. This prediction remained stable even after adjusting for possible confounders including age, sex, glomerular filtration rate, and NT-proBNP. Furthermore, the prediction was even more valuable when combining galectin-3 with NTproBNP. In summary elevated galectin-3 levels are associated with adverse outcome after TAVI. Combining galectin-3 with NT-proBNP provides additive predictive value of risk stratification.
authors.affiliation: Medizinische Klinik für Kardiologie und Angiologie, Charité Campus Mitte - Universitätsmedizin Berlin, Germany.
authors.forename: Gerd
authors.initials: G
authors.lastname: Baldenhofer
authors.affiliation: Medizinische Klinik für Kardiologie und Angiologie, Charité Campus Mitte - Universitätsmedizin Berlin, Germany.
authors.forename: Kun
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Medizinische Klinik für Kardiologie und Angiologie, Charité Campus Mitte - Universitätsmedizin Berlin, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Spethmann
authors.affiliation: Medizinische Klinik für Kardiologie und Angiologie, Charité Campus Mitte - Universitätsmedizin Berlin, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Laule
authors.affiliation: Labor Berlin - Charité Vivantes Services GmbH, Berlin, Germany.
authors.forename: Björn
authors.initials: B
authors.lastname: Eilers
authors.affiliation: Medizinische Klinik für Kardiologie und Angiologie, Charité Campus Mitte - Universitätsmedizin Berlin, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Leonhardt
authors.affiliation: Medizinische Klinik für Kardiologie und Angiologie, Charité Campus Mitte - Universitätsmedizin Berlin, Germany.
authors.forename: Wasiem
authors.initials: W
authors.lastname: Sanad
authors.affiliation: Medizinische Klinik für Kardiologie und Angiologie, Charité Campus Mitte - Universitätsmedizin Berlin, Germany.
authors.forename: Henryk
authors.initials: H
authors.lastname: Dreger
authors.affiliation: Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité Campus Mitte - Universitätsmedizin Berlin, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Sander
authors.affiliation: Klinik für Kardiovaskuläre Chirurgie, Charité Campus Mitte - Universitätsmedizin Berlin, Germany.
authors.forename: Herko
authors.initials: H
authors.lastname: Grubitzsch
authors.affiliation: Medizinische Klinik für Kardiologie und Angiologie, Charité Campus Mitte - Universitätsmedizin Berlin, Germany.
authors.forename: Gert
authors.initials: G
authors.lastname: Baumann
authors.affiliation: Medizinische Klinik für Kardiologie und Angiologie, Charité Campus Mitte - Universitätsmedizin Berlin, Germany. Electronic address: karl.stangl@charite.de.
authors.forename: Karl
authors.initials: K
authors.lastname: Stangl
authors.affiliation: Medizinische Klinik für Kardiologie und Angiologie, Charité Campus Mitte - Universitätsmedizin Berlin, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Stangl
authors.affiliation: Medizinische Klinik für Kardiologie und Angiologie, Charité Campus Mitte - Universitätsmedizin Berlin, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Knebel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000097:blood* / Q000175:diagnosis / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects / Q000639:trends*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D037502:Galectin 3
keywords: Aortic valve stenosis; Galectin-3; Transcatheter aortic valve implantation