Galectin-3, a marker of cardiac fibrosis, predicts incident heart failure in the community

Jennifer E. Ho, Chunyu Liu, Asya Lyass, Paul Courchesne, Michael J. Pencina, Ramachandran S. Vasan, Martin G. Larson, Daniel Levy

Research output: Contribution to journalArticlepeer-review

426 Scopus citations

Abstract

Objectives: The aim of this study was to examine the relation of galectin-3 (Gal-3), a marker of cardiac fibrosis, with incident heart failure (HF) in the community. Background: Gal-3 is an emerging prognostic biomarker in HF, and experimental studies suggest that Gal-3 is an important mediator of cardiac fibrosis. Whether elevated Gal-3 concentrations precede the development of HF is unknown. Methods: Gal-3 concentrations were measured in 3,353 participants in the Framingham Offspring Cohort (mean age 59 years; 53% women). The relation of Gal-3 to incident HF was assessed using proportional hazards regression. Results: Gal-3 was associated with increased left ventricular mass in age-adjusted and sex-adjusted analyses (p = 0.001); this association was attenuated in multivariate analyses (p = 0.06). A total of 166 participants developed incident HF and 468 died during a mean follow-up period of 11.2 years. Gal-3 was associated with risk for incident HF (hazard ratio [HR]: 1.28 per 1 SD increase in log Gal-3; 95% confidence interval [CI]: 1.14 to 1.43; p < 0.0001) and remained significant after adjustment for clinical variables and B-type natriuretic peptide (HR: 1.23; 95% CI: 1.04 to 1.47; p = 0.02). Gal-3 was also associated with risk for all-cause mortality (multivariable-adjusted HR: 1.15; 95% CI: 1.04 to 1.28; p = 0.01). The addition of Gal-3 to clinical factors resulted in negligible changes to the C-statistic and minor improvements in net reclassification improvement. Conclusions: Higher concentration of Gal-3, a marker of cardiac fibrosis, is associated with increased risk for incident HF and mortality. Future studies evaluating the role of Gal-3 in cardiac remodeling may provide further insights into the role of Gal-3 in the pathophysiology of HF.

Original languageEnglish (US)
Pages (from-to)1249-1256
Number of pages8
JournalJournal of the American College of Cardiology
Volume60
Issue number14
DOIs
StatePublished - Oct 2 2012
Externally publishedYes

Keywords

  • biomarker
  • epidemiology
  • heart failure
  • prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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