The Prognostic Value of Galectin-3 and Nt-Probnp in Patients Undergoing Transcatheter Aortic Valve Implantation

Liebetrau, Christoph; Gaede, Luise; Wolter, Sebastian; Hoffmann, Jedrzej; Troidl, Christian; Dörr, Oliver; Kim, Won K.; Walther, Thomas; Hamm, Christian W.; Nef, Holger; Möllmann, Helge

doi:10.1016/s0735-1097(14)62000-3

Cited by 2 publications

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“…Third, only galectin-3 before procedure was investigated in our study. It has been proposed that reduction in circulating galectin-3 after TAVR may predict better survival [ 34 ]. The influence of dynamic changes of galectin-3 during the periprocedural period of TAVR on mortality risk in these patients deserves further investigation.…”

Section: Discussionmentioning

confidence: 99%

Preprocedural circulating galectin-3 and the risk of mortality after transcatheter aortic valve replacement: a systematic review and meta-analysis

et al. 2020

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Background: Galectin-3 may predict mortality for patients with aortic stenosis (AS) after transcatheter aortic valve replacement (TAVR). However, the results were inconsistent. We aimed to evaluate the association between baseline galectin and mortality after TAVR in a meta-analysis. Methods: Related follow-up studies were obtained by systematic search of PubMed, Cochrane’s Library, and Embase databases. Both the fixed and the random-effect models were used for the meta-analysis. Subgroup analyses were performed to evaluate the influences of study characteristics on the outcome. Results: Five prospective cohort studies with 854 patients were included, with a follow-up period between 1-1.9 years. Patients with higher baseline circulating galectin-3 had an increased risk of all-cause mortality after TAVR (random-effect model: risk ratio [RR]: 1.63, 95% confidence interval [CI]: 1.19 to 2.23, P = 0.002; fixed effect model: RR: 1.62, 95% CI: 1.19 to 2.20, P = 0.002; I2 = 4%). Adjustment of estimated glomerular filtration rate (RR: 1.73, P = 0.02) or B type natriuretic peptide or N-terminal pro B type natriuretic peptide (RR: 1.83, P = 0.02) did not significantly affect the result. A trend of stronger association between higher baseline circulating galectin-3 and increased risk of all-cause mortality after TAVR was observed in studies with an enzyme-linked fluorescent assay (RR: 3.04, P = 0.003) compared to those with an enzyme linked immunosorbent assay (RR: 1.42, P = 0.04; P for subgroup difference = 0.06). Conclusions: Higher circulating galectin-3 before the procedure may predict all-cause mortality of AS patients after TAVR.

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Section: Discussionmentioning

confidence: 99%

Preprocedural circulating galectin-3 and the risk of mortality after transcatheter aortic valve replacement: a systematic review and meta-analysis

et al. 2020

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“…According to Baldenhofer et al [ 21 ], in 101 patients after TAVI, pre-procedural Gal-3 predicted both all-cause mortality and cardiovascular events over one year, which was not affected upon multivariate adjustment, including eGFR and NT-proBNP. On the other hand, Liebetrau et al [ 23 ] described a prognostic effect of post-procedural but not pre-procedural Gal-3 on one-year mortality in 184 subjects undergoing TAVI, which suggests a role of unidentified peri-procedural factors. In addition, although Lindman et al [ 22 ] observed a univariate association of pre-procedural Gal-3 with mortality over a mean follow-up of about 2 years in 345 subjects with severe AS referred for valve replacement (via transcatheter or surgical approach), nonetheless, the significance of the effect was lost on multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, conflicting results were reported with regard to the prognostic ability of pre-procedural Gal-3 in AS patients undergoing valve replacement. In particular, pre-procedural Gal-3 either independently predicted all-cause mortality [ 21 ], was predictive only on univariate analysis [ 22 ], or lacked any relationship with survival [ 23 ]. Finally, a comparison of the prognostic effect of Gal-3 between different treatment modalities for severe AS stenosis has not been reported so far.…”

Section: Introductionmentioning

confidence: 99%

Clinical Correlates and Prognostic Value of Plasma Galectin-3 Levels in Degenerative Aortic Stenosis: A Single-Center Prospective Study of Patients Referred for Invasive Treatment

Bobrowska

Wieczorek-Surdacka

Kruszelnicka

et al. 2017

IJMS

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Galectin-3 (Gal-3), a β-galactoside-binding lectin, has been implicated in myocardial fibrosis, development of left ventricular (LV) dysfunction and transition from compensated LV hypertrophy to overt heart failure (HF), being a novel prognostic marker in HF. Risk stratification is crucial for the choice of the optimal therapy in degenerative aortic stenosis (AS), affecting elderly subjects with coexistent diseases. Our aim was to assess correlates and prognostic value of circulating Gal-3 in real-world patients with degenerative AS referred for invasive treatment. Gal-3 levels were measured at admission in 80 consecutive patients with symptomatic degenerative AS (mean age: 79 ± 8 years; aortic valve area (AVA) index: 0.4 ± 0.1 cm2/m2). The therapeutic strategy was chosen following a dedicated multidisciplinary team-oriented approach, including surgical valve replacement (n = 11), transcatheter valve implantation (n = 19), balloon aortic valvuloplasty (BAV) (n = 25) and optimal medical therapy (n = 25). Besides routine echocardiographic indices, valvulo-arterial impedance (Zva), an index of global LV afterload, was computed. There were 22 deaths over a median follow-up of 523 days. Baseline Gal-3 correlated negatively with estimated glomerular filtration rate (eGFR) (r = −0.61, p < 0.001) and was unrelated to age, symptomatic status, AVA index, LV ejection fraction, LV mass index or Zva. For the study group as a whole, Gal-3 tended to predict mortality (Gal-3 >17.8 vs. Gal-3 <17.8 ng/mL; hazard ratio (HR): 2.03 (95% confidence interval, 0.88–4.69), p = 0.09), which was abolished upon adjustment for eGFR (HR: 1.70 (0.61–4.73), p = 0.3). However, in post-BAV patients multivariate-adjusted pre-procedural Gal-3 was associated with worse survival (HR: 7.41 (1.52–36.1), p = 0.01) regardless of eGFR. In conclusion, the inverse eGFR–Gal-3 relationship underlies a weak association between Gal-3 and adverse outcome in patients with degenerative AS referred for invasive therapy irrespective of type of treatment employed. In contrast, pre-procedural Gal-3 appears an independent mortality predictor in high-risk AS patients undergoing BAV.

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The Prognostic Value of Galectin-3 and Nt-Probnp in Patients Undergoing Transcatheter Aortic Valve Implantation

Cited by 2 publications

References 0 publications

Preprocedural circulating galectin-3 and the risk of mortality after transcatheter aortic valve replacement: a systematic review and meta-analysis

Preprocedural circulating galectin-3 and the risk of mortality after transcatheter aortic valve replacement: a systematic review and meta-analysis

Clinical Correlates and Prognostic Value of Plasma Galectin-3 Levels in Degenerative Aortic Stenosis: A Single-Center Prospective Study of Patients Referred for Invasive Treatment

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