title: Role of galectin-3 and plasma B type-natriuretic peptide in predicting prognosis in discharged chronic heart failure patients.
abstract: Galectin-3 demonstrated to be a robust independent marker of cardiovascular mid-term (18-month) outcome in heart failure (HF) patients. The objective of this study was to analyze the value of a predischarged determination of plasma galectin-3 alone and with plasma brain natriuretic peptide (BNP) in predicting mid-term outcome in frequent-flyers (FF) HF (≥2 hospitalization for HF/year)/dead patients discharged after an acute decompensated HF (ADHF) episode.All FF chronic HF subjects discharged alive after an ADHF were enrolled. All patients underwent a determination of BNP and galectin-3, a 6-minute walk test, and an echocardiogram within 48 hours upon hospital discharge. Death by any cause, cardiac transplantation, and worsening HF requiring readmission to hospital were considered cardiovascular events.Eighty-three patients (67 males, age 73.2 ± 8.6 years old) were analyzed (mean follow-up 11.6 ± 5.2 months; range 4-22 months). During the follow-up 38 events (45.7%) were scheduled: (13 cardiac deaths, 35 rehospitalizations for ADHF). According to medical history, in 33 patients (39.8%) a definition of FF HF patients was performed (range 2-4 hospitalization/year). HF patients who suffered an event (FF or death) demonstrated more impaired ventricular function (P = 0.037), higher plasma BNP (P = 0.005), and Gal-3 at predischarge evaluation (P = 0.027). Choosing adequate cut-off points (BNP ≥ 500 pg/mL and Gal-3 ≥ 17.6 ng/mL), the Kaplan-Meier curves depicted the powerful stratification using BNP + Gal-3 in predicting clinical course at mid-term follow-up (log rank 5.65; P = 0.017).Adding Gal-3 to BNP, a single predischarge strategy testing seemed to obtain a satisfactorily predictive value in alive HF patients discharged after an ADHF episode.
authors.affiliation: aCardiovascular Rehabilitation-Heart Failure Unit, Ospedale SS Trinità Fossano bSchool of Geriatry, Università degli Studi Torino cLaboratory Service Ospedale Mondovì dMedical Emergency Service, ASL CN1-Cuneo, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Feola
authors.forename: Marzia
authors.initials: M
authors.lastname: Testa
authors.forename: Laura
authors.initials: L
authors.lastname: Leto
authors.forename: Marco
authors.initials: M
authors.lastname: Cardone
authors.forename: Mario
authors.initials: M
authors.lastname: Sola
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Rosso
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D006333:Heart Failure / Q000097:blood* / Q000401:mortality*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011379:Prognosis
chemical_list: D037502:Galectin 3; D020097:Natriuretic Peptide, Brain