title: The prognostic value of plasma galectin-3 in chronic heart failure patients is maintained when treated with mineralocorticoid receptor antagonists.
abstract: OBJECTIVE
  Galectin-3 (Gal-3) is considered as a myocardial fibrosis biomarker with prognostic value in heart failure (HF). Since aldosterone is a neurohormone with established fibrotic properties, we aimed to investigate if mineralocorticoid receptor antagonists (MRAs) would modulate the prognostic value of Gal-3.
  
  
  METHODS
  The IBLOMAVED cohort comprised 427 eligible chronic HF patients (CHF) with echocardiography and heart failure biomarkers assessments (BNP). After propensity score matching CHF patients for cardiovascular risk factors, to form balanced groups, Gal-3 levels were measured at baseline in plasma from patients treated with MRAs (MRA-Plus, n=101) or not (MRA-Neg, n=101). The primary end point was all-cause mortality with a follow-up of 3 years.
  
  
  RESULTS
  Gal-3 in plasma from these patients were similar with median values of 14.0 ng/mL [IQR, 9.9-19.3] and 14.4 ng/mL [IQR, 12.3-19.8] (P = 0.132) in MRA-Neg and MRA-Plus, respectively. Patients with Gal-3 ≤17.8 ng/mL had an HR of 1 (reference group) and 1.5 [0.4-5.7] in MRA-Neg and MRA-Plus, respectively (p=0.509). Patients with Gal-3 ≥ 17.8 ng/mL had an HR of 7.4 [2.2-24.6] and 9.0 [2.9-27.8] in MRA-Plus and MRA-Neg, respectively (p=0.539) and a median survival time of 2.4 years [95%CI,1.8-2.4]. Multivariate Cox proportional hazard analysis confirmed that MRA and the interaction term between MRA treatment and Gal-3 >17.8 ng/mL were not factors associated with survival.
  
  
  CONCLUSIONS
  MRA treatment did not impair the prognostic value of Gal-3 assessed with a 17.8 ng/mL cut off. Gal-3 levels maintained its strong prognostic value in CHF also in patients treated with MRAs. The significance of the observed lack of an interaction between Gal-3 and treatment effect of MRAs remains to be elucidated.
authors.affiliation: INSERM I2MC, UMR 1048, Université UPS, Equipe, Obésité et insuffisance cardiaque: approches moléculaires et cliniques, F-31432 Toulouse, France.
authors.forename: François
authors.initials: F
authors.lastname: Koukoui
authors.affiliation: INSERM I2MC, UMR 1048, Université UPS, Equipe, Obésité et insuffisance cardiaque: approches moléculaires et cliniques, F-31432 Toulouse, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Desmoulin
authors.affiliation: INSERM I2MC, UMR 1048, Université UPS, Equipe, Obésité et insuffisance cardiaque: approches moléculaires et cliniques, F-31432 Toulouse, France; CHU de Rangueil, Service de Cardiologie A, F-31432 Toulouse, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Galinier
authors.affiliation: INSERM I2MC, UMR 1048, Université UPS, Equipe, Obésité et insuffisance cardiaque: approches moléculaires et cliniques, F-31432 Toulouse, France.
authors.forename: Manon
authors.initials: M
authors.lastname: Barutaut
authors.affiliation: INSERM I2MC, UMR 1048, Université UPS, Equipe, Obésité et insuffisance cardiaque: approches moléculaires et cliniques, F-31432 Toulouse, France.
authors.forename: Celine
authors.initials: C
authors.lastname: Caubère
authors.affiliation: INSERM I2MC, UMR 1048, Université UPS, Equipe, Obésité et insuffisance cardiaque: approches moléculaires et cliniques, F-31432 Toulouse, France.
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Evaristi
authors.affiliation: INSERM I2MC, UMR 1048, Université UPS, Equipe, Obésité et insuffisance cardiaque: approches moléculaires et cliniques, F-31432 Toulouse, France; CHU de Rangueil, Service de Cardiologie A, F-31432 Toulouse, France.
authors.forename: Gurbuz
authors.initials: G
authors.lastname: Murat
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Rudolf
authors.initials: R
authors.lastname: De Boer
authors.affiliation: INSERM I2MC, UMR 1048, Université UPS, Equipe, Obésité et insuffisance cardiaque: approches moléculaires et cliniques, F-31432 Toulouse, France; CHU de Rangueil, Service de Cardiologie A, F-31432 Toulouse, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Berry
authors.affiliation: INSERM I2MC, UMR 1048, Université UPS, Equipe, Obésité et insuffisance cardiaque: approches moléculaires et cliniques, F-31432 Toulouse, France.
authors.forename: Fatima
authors.initials: F
authors.lastname: Smih
authors.affiliation: INSERM I2MC, UMR 1048, Université UPS, Equipe, Obésité et insuffisance cardiaque: approches moléculaires et cliniques, F-31432 Toulouse, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Rouet
mesh_terms: D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D006333:Heart Failure / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D037502:Galectin 3; D000451:Mineralocorticoid Receptor Antagonists