open access

Vol 23, No 5 (2016)
BASIC SCIENCE AND EXPERIMENTALNTAL CARDIOLOGY - ORIGINAL ARTICLES
Published online: 2016-08-01
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Estimating systemic fibrosis by combining galectin-3 and ST2 provides powerful risk stratification value for patients after acute decompensated heart failure

Chao-Hung Wang, Ning-I Yang, Min-Hui Liu, Kuang-Hung Hsu, Li-Tang Kuo
DOI: 10.5603/CJ.a2016.0053
·
Pubmed: 27515479
·
Cardiol J 2016;23(5):563-572.

open access

Vol 23, No 5 (2016)
BASIC SCIENCE AND EXPERIMENTALNTAL CARDIOLOGY - ORIGINAL ARTICLES
Published online: 2016-08-01

Abstract

Background: Two fibrosis biomarkers, galectin-3 (Gal-3) and suppression of tumorigenicity 2 (ST2), provide prognostic value additive to natriuretic peptides and traditional risk factors in patients with heart failure (HF). However, it is to be investigated whether their combined measurement before discharge provides incremental risk stratification for patients after acute HF.

Methods: A total of 344 patients with acute HF were analyzed with Gal-3, and ST2 measured. Patients were prospectively followed for 3.7 ± 1.3 years for deaths, and composite events (death/HF-related re-hospitalizations).

Results: The levels of Gal-3 and ST2 were only slightly related (r = 0.20, p < 0.001). The medians of Gal-3 and ST2 were 18 ng/mL and 32.4 ng/mL, respectively. These biomarkers compensated each other and characterized patients with different risk factors. According to the cutoff at median values, patients were separated into four subgroups based on high and low Gal-3 (HG and LG, respectively) and ST2 levels (HS and LS, respectively). Kaplan-Meier survival curves showed that HGHS powerfully identified patients at risk of mortality (Log rank = 21.27, p < 0.001). In multivariable analysis, combined log(Gal-3) and log(ST2) was an in­dependent predictor. For composite events, Kaplan-Meier survival curves showed a lower event- -free survival rate in the HGHS subgroup compared to others (Log rank = 34.62, p < 0.001; HGHS vs. HGLS, Log rank = 4.00, p = 0.045). In multivariable analysis, combined log(Gal-3) and log(ST2) was also an independent predictor.

Conclusions: Combination of biomarkers involving heterogeneous fibrosis pathways may identify patients with high systemic fibrosis, providing powerful risk stratification value.

Abstract

Background: Two fibrosis biomarkers, galectin-3 (Gal-3) and suppression of tumorigenicity 2 (ST2), provide prognostic value additive to natriuretic peptides and traditional risk factors in patients with heart failure (HF). However, it is to be investigated whether their combined measurement before discharge provides incremental risk stratification for patients after acute HF.

Methods: A total of 344 patients with acute HF were analyzed with Gal-3, and ST2 measured. Patients were prospectively followed for 3.7 ± 1.3 years for deaths, and composite events (death/HF-related re-hospitalizations).

Results: The levels of Gal-3 and ST2 were only slightly related (r = 0.20, p < 0.001). The medians of Gal-3 and ST2 were 18 ng/mL and 32.4 ng/mL, respectively. These biomarkers compensated each other and characterized patients with different risk factors. According to the cutoff at median values, patients were separated into four subgroups based on high and low Gal-3 (HG and LG, respectively) and ST2 levels (HS and LS, respectively). Kaplan-Meier survival curves showed that HGHS powerfully identified patients at risk of mortality (Log rank = 21.27, p < 0.001). In multivariable analysis, combined log(Gal-3) and log(ST2) was an in­dependent predictor. For composite events, Kaplan-Meier survival curves showed a lower event- -free survival rate in the HGHS subgroup compared to others (Log rank = 34.62, p < 0.001; HGHS vs. HGLS, Log rank = 4.00, p = 0.045). In multivariable analysis, combined log(Gal-3) and log(ST2) was also an independent predictor.

Conclusions: Combination of biomarkers involving heterogeneous fibrosis pathways may identify patients with high systemic fibrosis, providing powerful risk stratification value.

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Keywords

galectin-3, suppression of tumorigenicity 2 (ST2), heart failure, prognosis

About this article
Title

Estimating systemic fibrosis by combining galectin-3 and ST2 provides powerful risk stratification value for patients after acute decompensated heart failure

Journal

Cardiology Journal

Issue

Vol 23, No 5 (2016)

Pages

563-572

Published online

2016-08-01

DOI

10.5603/CJ.a2016.0053

Pubmed

27515479

Bibliographic record

Cardiol J 2016;23(5):563-572.

Keywords

galectin-3
suppression of tumorigenicity 2 (ST2)
heart failure
prognosis

Authors

Chao-Hung Wang
Ning-I Yang
Min-Hui Liu
Kuang-Hung Hsu
Li-Tang Kuo

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