Role of galectin-3 and plasma B type-natriuretic peptide in predicting prognosis in discharged chronic heart failure patients

Abstract

Galectin-3 demonstrated to be a robust independent marker of cardiovascular mid-term (18-month) outcome in heart failure (HF) patients. The objective of this study was to analyze the value of a predischarged determination of plasma galectin-3 alone and with plasma brain natriuretic peptide (BNP) in predicting mid-term outcome in frequent-flyers (FF) HF (≥2 hospitalization for HF/year)/dead patients discharged after an acute decompensated HF (ADHF) episode.All FF chronic HF subjects discharged alive after an ADHF were enrolled. All patients underwent a determination of BNP and galectin-3, a 6-minute walk test, and an echocardiogram within 48 hours upon hospital discharge. Death by any cause, cardiac transplantation, and worsening HF requiring readmission to hospital were considered cardiovascular events.Eighty-three patients (67 males, age 73.2 ± 8.6 years old) were analyzed (mean follow-up 11.6 ± 5.2 months; range 4–22 months). During the follow-up 38 events (45.7%) were scheduled: (13 cardiac deaths, 35 rehospitalizations for ADHF). According to medical history, in 33 patients (39.8%) a definition of FF HF patients was performed (range 2–4 hospitalization/year). HF patients who suffered an event (FF or death) demonstrated more impaired ventricular function (P = 0.037), higher plasma BNP (P = 0.005), and Gal-3 at predischarge evaluation (P = 0.027). Choosing adequate cut-off points (BNP ≥ 500 pg/mL and Gal-3 ≥ 17.6 ng/mL), the Kaplan–Meier curves depicted the powerful stratification using BNP + Gal-3 in predicting clinical course at mid-term follow-up (log rank 5.65; P = 0.017).Adding Gal-3 to BNP, a single predischarge strategy testing seemed to obtain a satisfactorily predictive value in alive HF patients discharged after an ADHF episode.

Galectin-3 as a novel biomarker for disease diagnosis and a target for therapy (Review)

“…The combination of galectin-3 with BNP provided an improved predictive value in discharged patients with HF following an acute decompensated HF episode compared to BNP alone ( 54 ). Galectin-3 alone as a risk predictor was not effective enough to assess sudden or in-hospital mortality, whereas combining galectin-3 and NT-proBNP levels significantly improved discrimination and reclassification when predicting all-cause and cardiovascular-associated mortality ( 55 ).…”

A retrospective study of traditional Chinese medicine as an adjunctive therapy for patients with chronic heart failure

“…[ 4 , 5 ] Its prevalence rate is reportedly 26 million worldwide, [ 5 ] and more frequent with increasing age, with 10% among patients more than 70 years. [ 5 – 7 ] It affects nearly 4.2 million people from China with 1.3% prevalence rates. [ 8 , 9 ] The incidence of CHF has been reported as 0.7 to 0.9 per 1000 in the Chinese population.…”

B-type natriuretic peptide levels and diagnostic accuracy: excess fluid volume

“…Sensitivity testing revealed that a many nurses established a correct diagnosis when the BNP cutoff value is 413 pg/ml. This indicates that patients with BNP values between 400 and 500 pg/ml are indeed presenting with ADHF, and that non-cardiac causes of congestion can be ruled out (19) .…”