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The GALA study: Relationship between galectin-3 serum levels and short- and long-term outcomes of patients with acute heart failure.

Research paper by Òscar Ò Miró, Bernardino B González de la Presa B, Pablo P Herrero, Rosa R Fernández Bonifacio, Martin M Möckel, Christian C Mueller, Gregori G Casals, Silvia S Sandalinas, Pere P Llorens, Francisco Javier FJ Martín-Sánchez, Javier J Jacob, José Luis JL Bedini, Víctor V Gil

Indexed on: 14 Apr '17Published on: 14 Apr '17Published in: Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals



Abstract

We tested the hypothesis that early measurement of galactin-3 at the emergency department (ED) during an episode of acute heart failure (AHF) allows predicting short- and long-term outcome.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, rehospitalisation or ED reconsultation, whichever first) and 1-year mortality.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.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.

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