The Association between Galectin-3 and hs-CRP and the Clinical Outcome after Non-ST-Elevation Myocardial Infarction with Preexisting Atrial Fibrillation

Abstract

Increased galectin-3 plasma concentration has been linked to an unfavorable outcome in patients with heart failure or atrial fibrillation (AF). There are no published data about the prognostic utility of galectin-3 and high-sensitivity C-reactive protein (hs-CRP) for long-term clinical outcome in the Non-ST elevation acute myocardial infarction (NSTEMI) patients with preexisting AF. Thirty-two patients with the first acute NSTEMI and preexisting AF and 22 patients without preexisting AF, were prospectively followed for fifteen months. Patients with AF had significantly higher galectin-3 plasma levels (p < 0.05) and hs-CRP concentration (p < 0.01), compared with patients without AF. Galectin-3 plasma concentration was not a significant covariate of the composite outcomes (p = 0.913). Patients with high hs-CRP (above 4.55 mg/L) showed 2.5 times increased risk (p < 0.05) of the composite outcome occurrence (p < 0.05). Besides, three-vessel coronary artery disease, creatinine serum level, and creatinine clearance were significant covariates (p < 0.05; p < 0.05; p < 0.01) of the composite outcome, respectively. Creatinine clearance, solely, has been shown to be an independent predictor of unfavorable prognosis after a 15-month follow-up. Galectin-3 and hs-CRP plasma levels were elevated in NSTEMI patients with AF, but with differential predictive value for an unfavorable clinical outcome. Only hs-CRP was associated with increased risk of composite outcome occurrence.

Galectin‐3 and risk of atrial fibrillation: A systematic review and meta‐analysis

“…Fourteen studies compared serum concentrations of galectin‐3 between the sinus rhythm group and AF group . Our meta‐analysis shows that the AF group had higher concentrations of galectin‐3 than the sinus rhythm (SR) group (mean difference [MD] = −0.68 ng/mL, 95% CI: −0.92, −0.44, Z = 5.61, P < .00001) (Figure A).…”

“…Among the 38 full‐text articles assessed for eligibility, ten were excluded for the following reasons: One study lacked a control group; one study population was heart failure; four studies lacked available data for further analysis; and four reported duplicate data from studies that later published as full text . Finally, 28 studies involving 10 830 patients were included in our meta‐analysis, with their baseline characteristics shown in Tables and .…”

“…Fourteen studies compared serum concentrations of galectin-3 between the sinus rhythm group and AF group. 26,28,29,[31][32][33]37,40,42,44,46,47,49,50 Our meta-analysis shows that the AF group had higher concentrations of galectin-3 than the sinus rhythm (SR) group (mean difference [MD] = −0.68 ng/mL, 95% CI: −0.92, −0.44, Z = 5.61, P < .00001) ( Figure 2A). Furthermore, we showed that higher galectin-3 levels were associated with a 45% increase in the odds of developing AF (odds ratio [OR] = 1.45, 95% CI: 1.15, 1.83, Z = 3.11, P = .002) ( Figure 2B).…”

<p>Effects of High-Dose Rosuvastatin on Ventricular Remodelling and Cardiac Function in ST-Segment Elevation Myocardial Infarction</p>

“…30,31 A previous study showed that reducing the level of inflammatory factors (hs-CRP, IL-6, TNF-α and ICAM-1) in patients with myocardial infarction can stabilize atheromatous plaques, improve endothelial function, reduce myocardial cell apoptosis, and retard slowdown or even reverse ventricular remodelling. [24][25][26][27][28][29][30][31] In this study, the levels of hs-CRP, IL-6, TNF-α and ICAM-1 were significantly reduced in the two groups after treatment with rosuvastatin. Compared with those of conventional-dose group, the levels of hs-CRP, IL-6, TNF-α and ICAM-1 were significantly lower in the high-dose group (P < 0.05).…”

Galectin-3 in Acute Myocardial Infarction Patients with Atrial Fibrillation

“…One study showed that galectin-3 and hs-CRP significantly increased in patients with NSTEMI with preexisting AF, compared with patients without AF. Also, hs-CRP, but not galectin-3, was a predictor of a worse outcome during the 15-month follow-up [22]. Szadkowska et al [23] found a weak relationship between 3 measured biomarkers: galectin-3, BNP and hs-CRP, which supports the observations that these proteins reflect different pathways in the pathophysiology of cardiac injury.…”