title: Galectin-3 predicts left ventricular remodelling after anterior-wall myocardial infarction treated by primary percutaneous coronary intervention.
abstract: Despite modern reperfusion therapies, left ventricular remodelling (LVR) occurs frequently after an ST-elevated myocardial infarction (STEMI) and represents a strong predictor of mortality and heart failure. Galectin-3 (Gal-3), a novel biomarker involved in inflammation, tissue repair and fibrogenesis, might be a valuable predictor of LVR.
  
  
  
  We enrolled consecutively admitted patients with a first anterior STEMI and left anterior descending artery occlusion treated by primary percutaneous coronary intervention (pPCI). Gal-3, N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiography and cardiovascular events were evaluated 48 hours after admission, at 1 and 6 months. LVR was defined as a ≥15% increase in LV end-systolic volume.
  
  
  
  We recruited 103 patients (28% women, aged 64.6±12 years, LV ejection fraction 47±11%). Median baseline Gal-3 and NT-proBNP levels were 13.2 ng/mL (10.8-17.1 ng/mL) and 2132 pg/mL (1019-4860 pg/mL) respectively. During 6 months of follow-up, 4 patients dropped out, 7 died and 26 (28.3%) of the 92 survivors developed LVR (LVR+). LVR+ patients had higher Gal-3 levels at baseline, 1 and 6 months than LVR- (p<0.0001). By univariable logistic regression, age, female gender, higher baseline Gal-3 and NT-proBNP, smaller LV end-diastolic volume (LVEDV) were associated to an increased risk of LVR. By multivariable analysis, only LVEDV (OR 0.96, 95% CI 0.93 to 0.99/1 mL change) and Gal-3 levels (OR 1.22, 95% CI 1.06 to 1.42/1 ng/mL change) independently predicted LVR (C-statistics 0.84, 95% CI 0.75 to 0.93).
  
  
  
  Gal-3 serum levels measured during hospitalisation could be clinically useful in predicting LVR among patients admitted with anterior STEMI treated by pPCI.
authors.affiliation: Division of Cardiology, ASST-Hospital of Cremona, Cremona, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Tano
authors.affiliation: Division of Cardiology, ASST-Hospital of Cremona, Cremona, Italy.|Division of Cardiology, Sant'Andrea Hospital, La Spezia, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Caretta
authors.affiliation: CNR Clinical Physiology Institute Cardiothoracic and Vascular Department ASST-Great Metropolitan Hospital Niguarda, Milan, Italy.
authors.forename: Renata
authors.initials: R
authors.lastname: De Maria
authors.affiliation: CNR Clinical Physiology Institute Cardiothoracic and Vascular Department ASST-Great Metropolitan Hospital Niguarda, Milan, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Parolini
authors.affiliation: Division of Laboratory Medicine, ASST-Hospital of Cremona, Cremona, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Bassi
authors.affiliation: Division of Laboratory Medicine, ASST-Hospital of Cremona, Cremona, Italy.
authors.forename: Sophie
authors.initials: S
authors.lastname: Testa
authors.affiliation: Division of Cardiology, ASST-Hospital of Cremona, Cremona, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Pirelli
mesh_terms: D000368:Aged; D056988:Anterior Wall Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D037502:Galectin 3 / Q000097:blood*; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D013318:Stroke Volume / Q000502:physiology; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D015415:Biomarkers; D037502:Galectin 3; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain