Galectin-3 Levels and Outcomes After Myocardial Infarction A Population-Based Study
Galectin-3 Levels and Outcomes After Myocardial Infarction A Population-Based Study
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DOI：
10.1016/j.jacc.2019.02.046
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发表时间：
2019-05-14
影响因子：
24
通讯作者：
Roger, Veronique L.
中科院分区：
文献类型：
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作者：
Asleh, Rabea;Enriquez-Sarano, Maurice;Roger, Veronique L.
背景半乳糖凝集素-3（Galectin-3，Gal-3）与心脏纤维化有关，但其与心肌梗死（MI）后不良结局的关系尚不清楚。结论本研究的目的是在社区MI发病队列中检测Gal-3的预后价值。在MI时测量Gal-3水平。结果：共有1,342例患者入组（平均年龄67.1岁; 61.3%为男性; 78.8%为非ST段抬高型心肌梗死）。Gal-3升高的患者年龄较大，合并症较多。在平均5.4年的随访中，484例患者（36.1%）死亡，368例（27.4%）发生HF。校正年龄、性别、合并症和肌钙蛋白后，Gal-3值在三分位数2和3的患者有1.3倍的（95%置信区间[CI]：0.9倍至1.7倍）和2.4倍与三分位数1中具有Gal-3值的患者相比，死亡风险分别增加（95%CI：1.8倍至3.2倍）（p（趋势）< 0.001）。Gal-3值在三分位数2和3的患者具有较高的HF风险，风险比分别为1.4（95%CI：1.0至2.0）和2.3（95%CI：1.6至3.2）（p（趋势）< 0.001）。随着对致瘤性-2可溶性抑制的进一步调整，Gal-3升高仍与死亡和HF风险增加相关。HF的风险增加并没有不同的HF类型，是独立的复发MI的发生。结论半乳糖苷-3是一个独立的预测死亡率和HF后MI。这些发现表明测量Gal-3水平对于MI后风险分层的作用。(C)2019年由美国心脏病学会基金会。
BACKGROUND Galectin-3 (Gal-3) is implicated in cardiac fibrosis, but its association with adverse outcomes after myocardial infarction (MI) is unknown.OBJECTIVES The purpose of this study was to examine the prognostic value of Gal-3 in a community cohort of incident MI.METHODS A population-based incidence MI cohort was prospectively assembled in Olmsted County, Minnesota, between 2002 and 2012. Gal-3 levels were measured at the time of MI. Patients were followed for heart failure (HF) and death.RESULTS A total of 1,342 patients were enrolled (mean age 67.1 years; 61.3% male; 78.8% non-ST-segment elevation MI). Patients with elevated Gal-3 were older and had more comorbidities. Over a mean follow-up of 5.4 years, 484 patients (36.1%) died and 368 (27.4%) developed HF. After adjustment for age, sex, comorbidities, and troponin, patients with Gal-3 values in tertiles 2 and 3 had a 1.3-fold (95% confidence interval [CI]: 0.9-fold to 1.7-fold) and a 2.4-fold (95% CI: 1.8-fold to 3.2-fold) increased risk of death, respectively (p(trend) < 0.001) compared with patients with Gal-3 values in tertile 1. Patients with Gal-3 values in tertiles 2 and 3 had a higher risk of HF with hazard ratios of 1.4 (95% CI: 1.0 to 2.0) and 2.3 (95% CI: 1.6 to 3.2), respectively (p(trend) < 0.001). With further adjustment for soluble suppression of tumorigenicity-2, elevated Gal-3 remained associated with increased risk of death and HF. The increased risk of HF did not differ by HF type and was independent of the occurrence of recurrent MI.CONCLUSIONS Gal-3 is an independent predictor of mortality and HF post-MI. These findings suggest a role for measuring Gal-3 levels for risk stratification post-MI. (C) 2019 by the American College of Cardiology Foundation.