The predictive value of galectin-3 for mortality and cardiovascular events in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA) - 28/11/12
, Thor Ueland, PhD b, c, i, John Kjekshus, MD, PhD a, i, Ståle H. Nymo, BSc b, c, i, Johannes Hulthe, MD, PhD d, e, i, Pieter Muntendam, MD f, i, John J.V. McMurray, MD g, i, John Wikstrand, MD, PhD d, i, Pål Aukrust, MD, PhD b, h, iRésumé |
Background |
Galectin-3 is a new biomarker involved in inflammation and fibrogenesis and could therefore contribute to myocardial remodeling. We examined the prognostic value of baseline galectin-3 in a substudy involving approximately 30% of participants in the CORONA study.
Methods |
Patients (n = 1462) aged >60 years with systolic, ischemic heart failure (HF) were randomized to 10 mg/d rosuvastatin or placebo. The primary composite end point was cardiovascular death, nonfatal myocardial infarction, or stroke (n = 408).
Results |
In the unadjusted analysis, galectin-3 was associated with all end points considered, except hospitalization for worsening of HF. In multivariable analyses, adjusting for other clinical and biochemical predictor variables, galectin-3 was significantly associated with the primary end point (hazard ratio [HR] 1.53 [1.10-2.12], P = .011) as well as all-cause (HR 1.61 [1.20-2.29], P = .002) and cardiovascular mortality (HR 1.70 [1.19-2.42], P = .003), sudden death (HR 1.83 [1.14-2.94], P = .012), and the coronary end point (HR 1.48 [1.03-2.12], P = .035). However, when N-terminal pro–brain natriuretic peptide was added to the model, galectin-3 association with the end points was markedly attenuated and no longer significant.
Conclusions |
Galectin-3 is not associated with outcome in older patients with advanced chronic systolic HF of ischemic etiology when adjusting for N-terminal pro–brain natriuretic peptide and may therefore have limited use in the prognostication of elderly patients with systolic HF in clinical practice.
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Vol 164 - N° 6
P. 878-883 - décembre 2012 Retour au numéro
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