TY - JOUR
T1 - Renal function largely influences Galectin-3 prognostic value in heart failure
AU - Zamora, Elisabet
AU - Lupón, Josep
AU - De Antonio, Marta
AU - Galán, Amparo
AU - Domingo, Mar
AU - Urrutia, Agustín
AU - Troya, Maribel
AU - Bayes-Genis, Antoni
PY - 2014/1/1
Y1 - 2014/1/1
N2 - © 2014 Elsevier Ireland Ltd. All rights reserved. Background Galectin-3 (Gal-3) has been associated with cardiac remodeling and heart failure (HF) prognosis. Renal function is also a well known HF prognostic indicator. The link between renal insufficiency, HF, and Gal-3 is not completely elucidated.Methods and results We explored the association between Gal-3 and renal function in a cohort of 876 consecutive ambulatory patients with HF (mean age: 68 years; mean left ventricular ejection fraction [LVEF]: 36%), 52.2% had HF etiology of ischemic heart disease. Circulating Gal-3 was highly correlated with estimated glomerular filtration rate (eGFR), calculated with either the chronic kidney disease-epidemiology (CKD-EPI) equation (r = - 0.64) or the CKD-EPI-cystatin-C equation (r = - 0.59) and with Cystatin-C levels (r = 0.70), after adjusting for age, sex, New York Heart Association (NYHA) functional class, LVEF, and HF etiology (all p < 0.001). Patients were stratified by CKD-EPI-eGFR (ml/min/1.73 m2), as follows: ≥ 60 (n = 218), 30 to 59 (n = 434), and < 30 (n = 224). In these strata, Gal-3 significantly increased (median [IQR]: 12.3 [10.4-15.6]; 16.1 [13-19.8]; and 24.5 [20-33.8] ng/ml, respectively; trend p < 0.001). This was independent of NYHA functional class (I-II and III-IV) and LVEF (< 45% and ≥ 45%). Gal-3 was associated with mortality in univariate analyses, but after adjusting for CKD-EPI-eGFR, the hazard ratios were 1.10 (95% CI: 0.89-1.34, p = 0.39) for all cause death, and 0.90 (95% CI: 0.68-1.21, p = 0.50) for cardiovascular death. Similar results were obtained with eGFRs calculated with the CKD-EPI-cystatin-C equation.Conclusion Circulating Gal-3 was highly associated with renal function in outpatients with HF. The value of Gal-3 for HF prognosis declined after adjusting for renal function.
AB - © 2014 Elsevier Ireland Ltd. All rights reserved. Background Galectin-3 (Gal-3) has been associated with cardiac remodeling and heart failure (HF) prognosis. Renal function is also a well known HF prognostic indicator. The link between renal insufficiency, HF, and Gal-3 is not completely elucidated.Methods and results We explored the association between Gal-3 and renal function in a cohort of 876 consecutive ambulatory patients with HF (mean age: 68 years; mean left ventricular ejection fraction [LVEF]: 36%), 52.2% had HF etiology of ischemic heart disease. Circulating Gal-3 was highly correlated with estimated glomerular filtration rate (eGFR), calculated with either the chronic kidney disease-epidemiology (CKD-EPI) equation (r = - 0.64) or the CKD-EPI-cystatin-C equation (r = - 0.59) and with Cystatin-C levels (r = 0.70), after adjusting for age, sex, New York Heart Association (NYHA) functional class, LVEF, and HF etiology (all p < 0.001). Patients were stratified by CKD-EPI-eGFR (ml/min/1.73 m2), as follows: ≥ 60 (n = 218), 30 to 59 (n = 434), and < 30 (n = 224). In these strata, Gal-3 significantly increased (median [IQR]: 12.3 [10.4-15.6]; 16.1 [13-19.8]; and 24.5 [20-33.8] ng/ml, respectively; trend p < 0.001). This was independent of NYHA functional class (I-II and III-IV) and LVEF (< 45% and ≥ 45%). Gal-3 was associated with mortality in univariate analyses, but after adjusting for CKD-EPI-eGFR, the hazard ratios were 1.10 (95% CI: 0.89-1.34, p = 0.39) for all cause death, and 0.90 (95% CI: 0.68-1.21, p = 0.50) for cardiovascular death. Similar results were obtained with eGFRs calculated with the CKD-EPI-cystatin-C equation.Conclusion Circulating Gal-3 was highly associated with renal function in outpatients with HF. The value of Gal-3 for HF prognosis declined after adjusting for renal function.
KW - Biomarkers
KW - Heart failure
KW - Myocardial fibrosis
KW - Remodeling
KW - Renal failure
U2 - 10.1016/j.ijcard.2014.09.011
DO - 10.1016/j.ijcard.2014.09.011
M3 - Article
VL - 177
SP - 171
EP - 177
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 1
ER -