ISSN 2996-8215
International Journal of Cardiology | Vol. 15, No. 10, October 2024 | pp. 73–80
DOI: 10.46882/2024/IJC/000186
Original Research Article
Long-Term Prognostic Value of Admission Plasma Galectin-3 Levels in Patients Hospitalized for Acute Decompensated Heart Failure
Stefan de Vries¹, Anika Janssen¹, Jan de Jong²
¹Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
²Division of Cardiovascular Medicine, Leiden University Medical Center, Leiden, Netherlands
Abstract:
Acute decompensated heart failure (ADHF) requires precise risk stratification to guide post-discharge transitions and prevent early rehospitalization. Galectin-3 is a soluble beta-galactoside-binding lectin secreted by activated macrophages that directly drives myocardial fibrosis and adverse chamber remodeling. This study evaluated the long-term prognostic value of plasma Galectin-3 levels measured at admission in a prospective cohort of patients hospitalized for ADHF. We enrolled 280 consecutive patients admitted with a primary diagnosis of ADHF. Plasma Galectin-3 concentrations were quantified using an enzyme-linked immunosorbent assay within 24 hours of hospital admission. The primary endpoint was a composite of 12-month all-cause mortality or heart failure readmission. High plasma Galectin-3 (defined as greater than 17.8 ng/mL) was identified in 48.2% of the study population. At 12 months, the primary composite endpoint occurred in 84 patients (30.0%). Survival analysis demonstrated a significantly lower event-free survival rate in the high Galectin-3 cohort compared to the low Galectin-3 group (41.5% vs. 19.3%, log-rank p < 0.001). After adjusting for age, left ventricular ejection fraction, estimated glomerular filtration rate, and N-terminal pro-B-type natriuretic peptide (NT-proBNP), multivariable Cox proportional hazards regression confirmed that elevated baseline Galectin-3 remained a powerful independent predictor of the composite outcome (hazard ratio: 1.84, 95% CI: 1.24–2.72, p = 0.002). Plasma Galectin-3 levels at admission provide robust, independent prognostic data in patients hospitalized for acute decompensated heart failure, identifying individuals at high risk for early post-discharge clinical worsening.
Keywords: Acute decompensated heart failure, Galectin-3, Biomarkers, Prognosis, Mortality, Heart failure readmission
Received: July 02, 2024; Revised: August 14, 2024; Accepted: September 05, 2024; Published: October 18, 2024