title: Diagnostic and prognostic accuracy of galectin-3 and soluble ST2 for acute heart failure.
abstract: BACKGROUND
  We aimed to compare head-to-head the diagnostic and prognostic capabilities of galectin-3, soluble ST2 (sST2) and B-type natriuretic peptide (BNP) for heart failure (HF) in an emergency setting.
  
  
  METHODS
  We studied 251 consecutive patients with dyspnoea as a chief compliant presenting to an emergency department. The diagnosis of HF was based on the Framingham score for HF plus echocardiographic evidence of systolic or diastolic dysfunction. All-cause mortality was assessed at one year. Plasma concentrations of galectin-3 and BNP were measured with two commercially available assays from Abbott Diagnostics, plasma concentrations of sST2 were quantified with the Presage ST2 assay. The diagnostic and prognostic accuracies of galectin-3, sST2 and BNP were assessed by receiver operating characteristic (ROC) curve analysis.
  
  
  RESULTS
  Of the 251 patients, 137 had dyspnoea attributable to acute HF and 114 had dyspnoea attributable to other reasons. BNP had a higher area under the curve (AUC) for the diagnosis of HF (0.92; 95% CI, 0.87-0.95) than galectin-3 (0.57; 95% CI, 0.51-0.64) and sST2 (0.63; 95% CI, 0.56-0.69). Of the 137 patients with acute HF, 41 died and 96 survived during follow up. The AUC of BNP for the prediction of one-year all-cause mortality in HF patients (0.72; 95% CI, 0.63-0.79) was not different from the AUCs of galectin-3 (0.70; 95% CI, 0.62-0.78) and sST2 (0.75; 95% CI, 0.67-0.82).
  
  
  CONCLUSIONS
  In this study, galectin-3, sST2 and BNP were equally useful for the prediction of one-year all-cause mortality in patients with acute HF. However, in contrast to BNP, galectin-3 and sST2 were not useful as an aid in the diagnosis of acute HF in short of breath patients presenting to an emergency department.
authors.affiliation: Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Austria. Electronic address: thomas.mueller@bs-lab.at.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mueller
authors.affiliation: Department of Internal Medicine, Krankenhaus Bad Ischl, Austria.
authors.forename: Alfons
authors.initials: A
authors.lastname: Gegenhuber
authors.affiliation: Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Austria.
authors.forename: Isabella
authors.initials: I
authors.lastname: Leitner
authors.affiliation: Institute for Applied System Sciences and Statistics, University of Linz, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Poelz
authors.affiliation: Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Austria.
authors.forename: Meinhard
authors.initials: M
authors.lastname: Haltmayer
authors.affiliation: Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Austria.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Dieplinger
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins; D004562:Electrocardiography; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D000072179:Interleukin-1 Receptor-Like 1 Protein / Q000097:blood* / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D037502:Galectin 3; D037161:Galectins; C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; C428445:LGALS3 protein, human; D020097:Natriuretic Peptide, Brain
keywords: Diagnostic accuracy; Galectins; Heart failure; Natriuretic peptides; Prognosis; ST2