Galectin-3 is Associated with Cardiovascular Events in Post-Acute Coronary Syndrome Patients with Type-2 Diabetes

Abstract

Introduction: Type-2 diabetes mellitus (T2DM) is associated with early and severe atherosclerosis. However, few biomarkers can predict cardiovascular events in this population. Methods: We followed 964 patients with coronary artery disease (CAD), assessing plasma levels of galectin-3, monocyte chemoattractant protein-1 (MCP-1), and N-terminal fragment of brain natriuretic peptide (NT-proBNP) at baseline. The secondary outcomes were acute ischemia and heart failure or death. The primary outcome was the combination of the secondary outcomes. Results. Two hundred thirty-two patients had T2DM. Patients with T2DM showed higher MCP-1 (144 (113–195) vs. 133 (105–173) pg/mL, p = 0.006) and galectin-3 (8.3 (6.5–10.5) vs. 7.8 (5.9–9.8) ng/mL, p = 0.049) levels as compared to patients without diabetes. Median follow-up was 5.39 years (2.81–6.92). Galectin-3 levels were associated with increased risk of the primary outcome in T2DM patients (Hazard ratio (HR) 1.57 (1.07–2.30); p = 0.022), along with a history of cerebrovascular events. Treatment with clopidogrel was associated with lower risk. In contrast, NT-proBNP and MCP-1, but not galectin-3, were related to increased risk of the event in nondiabetic patients (HR 1.21 (1.04–1.42); p = 0.017 and HR 1.23 (1.05–1.44); p = 0.012, respectively), along with male sex and age. Galectin-3 was also the only biomarker associated with the development of acute ischemic events and heart failure or death in T2DM patients, while, in nondiabetics, MCP-1 and NT-proBNP, respectively, were related to these events. Conclusion: In CAD patients, galectin-3 plasma levels are associated with cardiovascular events in patients with T2DM, and MCP-1 and NT-proBNP in those without T2DM.

MCP-1 Predicts Recurrent Cardiovascular Events in Patients with Persistent Inflammation

“…However, the A to Z trial showed that MCP-1 levels did not change during follow-up after acute coronary syndrome [ 26 ]. Finally, data from the Biomarkers in Acute Coronary Syndrome & Biomarkers in Acute Myocardial Infarction (BACS-BAMI) database were used, however the findings reported here are different from those reported in previous papers [ 11 , 35 ].…”

“…The research protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki, as reflected in a priori approval by the human research committees of the institutions participating in this study: Fundación Jiménez Díaz, Hospital Fundación Alcorcón, Hospital de Fuenlabrada, Hospital Universitario Puerta de Hierro-Majadahonda and Hospital Universitario de Móstoles (code 25/2007, 24 April 2007), as previously described [ 35 ]. All patients signed informed consent documents.…”

Serum Galectin-3 and Subsequent Risk of Coronary Heart Disease in Subjects With Childhood-Onset Type 1 Diabetes: A Cohort Study

“…In a recent Spanish study in which researchers followed subjects (mean age >60 years) with coronary artery disease, subjects with type 2 diabetes had higher values of galectin-3 compared with those without. Out of several studied markers, galectin-3 was the only one significantly associated with a future acute ischemic event ( 32 ). A potential effect of galectin-3 on the risk of CHD in subjects with type 1 diabetes, consistent with findings in other studies, associates galectin-3 with cardiac malfunction ( 18 , 24 , 33 , 34 ).…”

Galectin-3 in Cardiovascular Diseases

“…A recent study highlighted that the association of high Gal-3 levels with cardiovascular events could be influenced by the presence of type-2 diabetes. In fact, Gal-3 plasma levels were associated with cardiovascular events in CAD patients with diabetes, whereas NT-proBNP in patients without diabetes [113].…”