Galectin-3 in ambulatory patients with heart failure: results from the HF-ACTION study.

Authors

• G Michael Felker
• Mona Fiuzat
• Linda K Shaw
• Robert Clare
• David J Whellan
• Luca Bettari
• Shailesh C Shirolkar
• Mark Donahue
• Dalane W Kitzman
• Faiez Zannad
• Ileana L Piña
• Christopher M O'Connor

Publication/Presentation Date

1-1-2012

Abstract

BACKGROUND: Galectin-3 is a soluble ß-galactoside-binding lectin released by activated cardiac macrophages. Elevated levels of galectin-3 have been found to be associated with adverse outcomes in patients with heart failure. We evaluated the association between galectin-3 and long-term clinical outcomes in ambulatory heart failure patients enrolled in the HF-ACTION study.

METHODS AND RESULTS: HF-ACTION was a randomized, controlled trial of exercise training in patients with chronic heart failure caused by left ventricular systolic dysfunction. Galectin-3 was assessed at baseline in a cohort of 895 HF-ACTION subjects with stored plasma samples available. The association between galectin-3 and clinical outcomes was assessed using a series of Cox proportional hazards models. Higher galectin-3 levels were associated with other measures of heart failure severity, including higher New York Heart Association class, lower systolic blood pressure, higher creatinine, higher amino-terminal proB-type natriuretic peptide (NTproBNP), and lower maximal oxygen consumption. In unadjusted analysis, there was a significant association between elevated galectin-3 levels and hospitalization-free survival (unadjusted hazard ratio, 1.14 per 3-ng/mL increase in galectin-3; P< 0.0001). In multivariable modeling, the prognostic impact of galectin-3 was significantly attenuated by the inclusion of other known predictors, and galectin-3 was no longer a significant predictor after the inclusion of NTproBNP.

CONCLUSIONS: Galectin-3 is elevated in ambulatory heart failure patients and is associated with poor functional capacity and other known measures of heart failure severity. In univariate analysis, galectin-3 was significantly predictive of long-term outcomes, but this association did not persist after adjustment for other predictors, especially NTproBNP.

CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00047437.

Volume

5

Issue

1

First Page

72

Last Page

78

ISSN

1941-3297

Published In/Presented At

Felker, G. M., Fiuzat, M., Shaw, L. K., Clare, R., Whellan, D. J., Bettari, L., Shirolkar, S. C., Donahue, M., Kitzman, D. W., Zannad, F., Piña, I. L., & O'Connor, C. M. (2012). Galectin-3 in ambulatory patients with heart failure: results from the HF-ACTION study. Circulation. Heart failure, 5(1), 72–78. https://doi.org/10.1161/CIRCHEARTFAILURE.111.963637

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

22016505

Department(s)

Administration and Leadership

Document Type

Article