Value and Level of Galectin-3 in Acute Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

Abstract

Aim: This study investigated the impact of the circulating galectin-3 level on the 30-day prognostic outcome in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).Results: The galectin-3 level was determined using ELISA. Our results demonstrated that the circulating level of galectin-3 was significantly higher in STEMI patients than in healthy control subjects (p＜0.001). As compared with patients with galectin-3 ＜7.67 ng/mL, patients with galectin-3 ≥ 7.67 ng/mL were significantly older, had significantly lower left ventricular ejection fraction and significantly higher frequency of elevated white blood cell count, advanced Killip score (defined as ≥ score 3), congestive heart failure (defined as ≥ New York Heart Association Functional Class Ⅲ), respiratory failure, unstable hemodynamics requiring a mechanical ventilator and intra-aortic balloon pump support, multiple vessel diseases and 30-day mortality (all p＜0.04). Furthermore, multivariate analysis showed that elevated circulating level of galectin-3 was the strongest independent predictor of the combined 30-day major adverse clinical outcome (MACO) (defined as advanced CHF or 30-day mortality) (p＜0.0001). Conclusion: A high circulating galectin-3 level may serve as a useful biomarker for predicting 30-day MACO in patients with STEMI undergoing primary PCI.

Galectin-3 in acute coronary syndrome

“…As described above, Tsai et al showed that circulating Gal-3 is a strong independent predictor of the combined 30-day MACO, defined as advanced congestive heart failure (CHF) and 30-day mortality (p < 0.0001), in STEMI patients undergoing pPCI [33]. Lisowska et al reported Gal-3 to predict mortality in mid-term follow-up of patients after AMI [8].…”

“…Firstly, the most common finding among such investigations is that circulating Gal-3 levels are elevated in ACS/AMI, being released during the acute phase of AMI [31,[33][34][35][36][37][38][39]. Indeed, Gal-3 could be part of a survival mechanism of the injured myocardium to cope with the ischemic insult [14].…”

“…Weir et al first explored the relationship between Gal-3 and LVR concluding that elevated baseline plasma Gal-3 levels are associated with lower left ventricular ejection fraction (LVEF), a wellknown indicator of poor outcome being associated to adverse LVR, at 24-weeks follow-up, but no at baseline, in patients with MI [34]. In the same year, Tsai et al showed a significant inverse correlation between Gal-3 and LVEF in STEMI patients treated by pPCI [33]. Most importantly, they found high Gal-3 levels were an independent predictor of 30-day major adverse clinical outcomes (MACO) among STEMI patients.…”

“…Some Authors evaluated the potential role of Gal-3 as a predictive marker of mortality, HF, atrial fibrillation (AF) and re-infarction in ACS patients [8,33,38,[50][51][52].…”

“…Moreover, elevated Gal-3 concentrations are a strong independent predictor of 30-day MACO (p < 0.0001) [33] Van der Velde et al Retrospective…”