Galectin-3 and the Development of Heart Failure after Acute Coronary Syndrome: Pilot Experience from PROVE IT-TIMI 22
Galectin-3 and the Development of Heart Failure after Acute Coronary Syndrome: Pilot Experience from PROVE IT-TIMI 22
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DOI：
10.1373/clinchem.2011.174359
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发表时间：
2012-01-01
影响因子：
9.3
通讯作者：
Morrow, David A.
中科院分区：
文献类型：
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作者：
Grandin, E. Wilson;Jarolim, Petr;Morrow, David A.
背景：Galectin-3 是一种 β-半乳糖苷结合凝集素，与心脏纤维化和重构有关，在易衰竭心脏模型中含量增加，并且对心力衰竭 (HF) 患者具有预后价值。 Galectin-3 与急性冠状动脉综合征 (ACS) 后发生心力衰竭之间的关系尚不清楚。 方法：在 PROVE IT-TIMI 22 中对 ACS 患者进行的一项巢式病例对照研究中，我们确定了 100 例因新发或恶化心力衰竭而住院的病例。对照组在年龄、性别、ACS 类型和随机治疗方面进行匹配 (1:1)。在基线（ACS 后 7 天内）测量血清半乳糖凝集素 3。 结果：发生心力衰竭的患者基线半乳糖凝集素 3 较高[中位数 16.7 μg/L（第 25、75 个百分位 14.0、20.6）对比 14.6 μg/L（12.0、17.6），P = 0.004]。基线半乳糖凝集素 3 高于中位数的患者发生心力衰竭的比值比为 2.1 (95% CI 1.2-3.6)，P = 0.010。 Galectin-3 与 HF 风险呈分级关系。病例更有可能患有高血压、糖尿病、既往心梗和心力衰竭；调整这些因素后，这种与半乳糖凝集素 3 四分位数和 HF 的分级关系仍然显着 [调整后 OR 1.4 (95% CI 1.1-1.9)，P = 0.020]。当将 BNP 添加到模型中时，galectin-3 与 HF 之间的关系减弱 [调整后的 OR 1.3 (95% CI: 0.96 -1.9)，P = 0.08]。结论：galectin-3 与 ACS 后发生 HF 风险相关的发现增加了新的证据，支持 galectin-3 作为导致 HF 的不良重塑的生物标志物以及潜在的治疗目标。 (C) 2011 美国临床化学协会
BACKGROUND: Galectin-3 is a beta-galactoside-binding lectin that has been implicated in cardiac fibrosis and remodeling, is increased in models of failure-prone hearts, and has prognostic value in patients with heart failure (HF). The relationship between galectin-3 and the development of HF after acute coronary syndrome (ACS) is unknown.METHODS: In a nested case-control study among patients with ACS in PROVE IT-TIMI 22, we identified 100 cases with a hospitalization for new or worsening HF. Controls were matched (1:1) for age, sex, ACS type, and randomized treatment. Serum galectin-3 was measured at baseline (within 7 days post-ACS).RESULTS: Patients who developed HF had higher baseline galectin-3 [median 16.7 mu g/L (25th, 75th percentile 14.0, 20.6) vs 14.6 mu g/L (12.0, 17.6), P = 0.004]. Patients with baseline galectin-3 above the median had an odds ratio of 2.1 (95% CI 1.2-3.6) for developing HF, P = 0.010. Galectin-3 showed a graded relationship with risk of HF. Cases were more likely to have hypertension, diabetes, prior MI, and prior HF; after adjustment for these factors, this graded relationship with galectin-3 quartile and HF remained significant [adjusted OR 1.4 (95% CI 1.1-1.9), P = 0.020]. When BNP was added to the model, the relationship between galectin-3 and HF was attenuated [adjusted OR 1.3 (95% CI: 0.96 -1.9), P = 0.08].CONCLUSIONS: The finding that galectin-3 is associated with the risk of developing HF following ACS adds to emerging evidence supporting galectin-3 as a biomarker of adverse remodeling contributing to HF as well as a potential therapeutic target. (C) 2011 American Association for Clinical Chemistry