title: The GALA study: relationship between galectin-3 serum levels and short- and long-term outcomes of patients with acute heart failure.
abstract: OBJECTIVE
  We tested the hypothesis that early measurement of galectin-3 at the emergency department (ED) during an episode of acute heart failure (AHF) allows predicting short- and long-term outcomes.
  
  
  METHODS
  We performed an exploratory study including 115 patients consecutively diagnosed with AHF in a single ED. Clinical and analytical variables were recorded. The primary endpoint was 30-day all-cause mortality, and secondary endpoints were 30-day composite outcome (death, rehospitalization or ED reconsultation, whichever first) and 1-year mortality.
  
  
  RESULTS
  Seven patients (6.1%) died within 30 days and 43 (37.4%) within 1 year. The 30-day composite endpoint was observed in 21.1% of patients. Galectin-3 was correlated with NT-proBNP and the glomerular filtration rate but not with age and s-cTnI. Measured at time of ED arrival, galectin-3 showed good discriminatory capacity for 30-day mortality (AUC ROC: 0.732; 95% CI 0.512-0.953; p = 0.041) but not for 1-year mortality (0.521; 0.408-0.633; p = 0.722). Patients with galectin-3 concentrations >42 μg/L had an OR = 7.67(95%CI = 1.57-37.53; p = 0.012) for 30-day mortality. Conversely, NT-proBNP only showed predictive capacity for 1-year mortality (0.642; 0.537-0.748; p = 0.014). Patients with NT-proBNP concentrations >5400 ng/L had an OR = 4.34 (95%CI = 1.93-9.77; p < 0.001) for 1-year mortality. These increased short- (galectin-3) and long-term (NT-proBNP) risks remained significant after adjustment for age or renal function. s-cTnI failed in both short- and long term death prediction. No biomarker predicted the short-term composite endpoint.
  
  
  CONCLUSIONS
  These results suggest that galectin-3 could help to monitor the risk of short-term mortality in unselected patients with AHF attended in the ED.
authors.affiliation: a Emergengy Department , Hospital Clínic; "Emergencies: processes and pathologies" Research Group, IDIBAPS , Barcelona , Spain.|b University of Barcelona , Barcelona , Spain.
authors.forename: Òscar
authors.initials: Ò
authors.lastname: Miró
authors.affiliation: c Core Laboratory , Hospital Clínic , Barcelona , Spain.
authors.forename: Bernardino
authors.initials: B
authors.lastname: González de la Presa
authors.affiliation: d Emergency Department , Hospital Universitario Central de Asturias , Oviedo , Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Herrero-Puente
authors.affiliation: c Core Laboratory , Hospital Clínic , Barcelona , Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Fernández Bonifacio
authors.affiliation: e Department of Cardiology, Division of Emergency Medicine , Charité-University Medicine Berlin , Berlin , Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Möckel
authors.affiliation: f Department of Cardiology & Cardiovascular Research Institute Basel , University Hospital Basel, University of Basel , Basel , Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Mueller
authors.affiliation: g Biochemistry and Molecular Genetics Department , Hospital Clínic de Barcelona , Barcelona , Spain.
authors.forename: Gregori
authors.initials: G
authors.lastname: Casals
authors.affiliation: c Core Laboratory , Hospital Clínic , Barcelona , Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Sandalinas
authors.affiliation: h Emergency Department, Home Hospitalization and Short Stay Unit , Hospital General de Alicante , Alicante , Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Llorens
authors.affiliation: i Emergency Department , Hospital Clínico San Carlos, Madrid, Universidad Complutense de Madrid , Madrid , Spain.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Martín-Sánchez
authors.affiliation: j Emergency Department , Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat , Barcelona , Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Jacob
authors.affiliation: c Core Laboratory , Hospital Clínic , Barcelona , Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Bedini
authors.affiliation: a Emergengy Department , Hospital Clínic; "Emergencies: processes and pathologies" Research Group, IDIBAPS , Barcelona , Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Gil
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D001798:Blood Proteins; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D012680:Sensitivity and Specificity; D015996:Survival Rate; D013997:Time Factors
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: ED revisit; Galectin-3; acute heart failure; biomarker; mortality; rehospitalization