Galectin-3 (Gal-3) may serve as an important independent predictor for mortality and heart failure (HF) after a myocardial infarction (MI), assisting in stratifying risk for patients with MI, according to study results published in JACC.

Medical records of a population of individuals who lived in Olmsted County, Minnesota, between 2002 and 2012 were used for the basis of the researchers’ analysis. Patients who were admitted to Mayo Clinic hospitals during this time frame with a cardiac troponin T level of ≥0.03 ng/mL were identified. At the time of MI incidence, patients had Gal-3 levels quantified and were followed for HF and death. The overall cohort was composed of 1342 patients with a mean age of 67.1±14.9 years (61.3% male; 78.8% non-ST-segment elevation MI).

Investigators categorized patients according to Gal-3 concentrations at admission: tertile 1, <15.1 ng/mL (n=449); tertile 2, 15.1 to 22.4 ng/mL (n=448); and tertile 3, >22.4 ng/mL (n=445).

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The mortality rate over a mean follow-up period of 5.4±3.5 years was 36.1%, whereas the HF rate during this follow-up was 27.4%. In the analysis adjusted for age, sex, comorbidities, and troponin, patients in the second and third tertiles had a higher risk for death compared with patients in tertile 1. The risk for mortality was 1.3-fold higher (hazard ratio [HR], 1.26; 95% CI, 0.93-1.70) in tertile 2 and 2.4-fold higher (HR, 2.35; 95% CI, 1.76-3.15) in tertile 3 (Ptrend <.001). Compared with tertile 1, the risk for HF was higher in tertiles 2 (HR, 1.40; 95% CI, 1.00-1.96) and 3 (HR, 2.25; 95% CI, 1.61-3.15; Ptrend <.001).

In an additional analysis that adjusted for soluble suppression of tumorigenicity-2, higher Gal-3 levels continued to maintain an association with a higher mortality and HF risk.

Limitations of the study included its observational design and the underrepresentation of patients with certain racial and ethnic backgrounds.

“The large excess risk of HF associated with Gal-3 does not differ by HF type,” the researchers added, “supporting its role in predicting [HF with reduced ejection fraction and HF with preserved ejection fraction] similarly.”

Reference

Asleh R, Enriquez-Sarano M, Jaffe AS, et al. Galectin-3 levels and outcomes after myocardial infarction: a population-based study. JACC. 2019:73(18):2286-2295.