title: Prognostic value of the interaction between galectin-3 and antigen carbohydrate 125 in acute heart failure.
abstract: OBJECTIVE
  Galectin-3 (Gal-3) and carbohydrate antigen 125 (CA125) have emerged as robust prognostic biomarkers in heart failure. Experimental data have also suggested a potential molecular interaction between CA125 and Gal-3; however, the biological and clinical relevance of this interaction is still uncertain. We sought to evaluate, in patients admitted for acute heart failure, the association between plasma Gal-3 with all-cause mortality and the risk for rehospitalizations among high and low levels of CA125.
  
  
  RESULTS
  We included 264 consecutive patients admitted for acute heart failure to the Cardiology Department in a third-level center. Both biomarkers were measured on admission. Negative binomial and Cox regression models were used to evaluate the prognostic effect of the interaction between Gal-3 and CA125 (dichotomized by its median) with hospital readmission and all-cause mortality, respectively. During a median follow-up of 2 years (IQR = 1-2.8), 108 (40.9%) patients deaths and 365 rehospitalizations in 171 (69.5%) patients were registered. In a multivariable setting, the effect of Gal-3 on mortality and rehospitalization was differentially mediated by CA125 (p = 0.007 and p<0.001, respectively). Indeed, in patients with CA125 above median (>67 U/ml), values across the continuum of Gal-3 showed a positive and almost linear relationship with either the risk of death or rehospitalization. Conversely, when CA125 was below median (≤67 U/ml), Gal-3 lacked any prognostic effect on both endpoints.
  
  
  CONCLUSIONS
  In patients with acute heart failure, Gal-3 was strongly associated with higher risk of long-term mortality and repeated rehospitalizations, but only in those patients exhibiting higher values of CA125 (above 67 U/ml).
authors: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universitat de Valencia, Valencia, Spain.
authors: Julio
authors: J
authors: Núñez
authors: Laboratorio de Inmunopatología, Instituto de Biología y Medicina Experimental (IBYME), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) and Facultad de Ciencias Exactas y Naturales (FCEyN), Universidad de Buenos Aires, Buenos Aires, Argentina.
authors: Gabriel A
authors: GA
authors: Rabinovich
authors: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universitat de Valencia, Valencia, Spain.
authors: Justo
authors: J
authors: Sandino
authors: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universitat de Valencia, Valencia, Spain.
authors: Luis
authors: L
authors: Mainar
authors: Servicio de Cardiología, Hospital de la Plana, Villa-real, Spain.
authors: Patricia
authors: P
authors: Palau
authors: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universitat de Valencia, Valencia, Spain.
authors: Enrique
authors: E
authors: Santas
authors: Servicio de Bioquímica Clínica, Hospital Clínico Universitario de Valencia, Valencia, Spain.
authors: Maria Pilar
authors: MP
authors: Villanueva
authors: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universitat de Valencia, Valencia, Spain.
authors: Eduardo
authors: E
authors: Núñez
authors: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universitat de Valencia, Valencia, Spain.
authors: Vicent
authors: V
authors: Bodí
authors: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universitat de Valencia, Valencia, Spain.
authors: Francisco J
authors: FJ
authors: Chorro
authors: Servicio de Cardiología, Hospital de Manises, Manises, Spain.
authors: Gema
authors: G
authors: Miñana
authors: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universitat de Valencia, Valencia, Spain.
authors: Juan
authors: J
authors: Sanchis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D001798:Blood Proteins; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D006333:Heart Failure / Q000097:blood* / Q000401:mortality / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D018394:CA-125 Antigen; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human