Abstract 12803: Galectin-3 is a Prognostic Biomarker for Patients After Transcatheter Aortic Valve Implantation

Abstract

Introduction: Until now, a reliable biomarker to predict the short- or long-term outcome for patients undergoing TAVI is still missing. Galectin-3, a novel marker indicative for myocardial fibrosis, has prognostic value in heart failure. Our goal was to investigate whether galectin-3 is suited for risk assessment in TAVI patients. Methods: We included 101 patients undergoing TAVI in this prospective, single-center, observational study. Baseline galectin-3 levels were correlated to the VARC 30-day safety and one-year efficacy endpoint as well as to total mortality and cardiovascular events at one year. Results: The VARC 30-day safety endpoint was reached by 24 patients. At one year, 43 patients met the VARC efficacy endpoint, 16 patients died, and 23 cardiovascular events were recorded. At baseline, mean galectin-3 level for the entire group was 18.1 (± 11.1) ng/ml. Of the 101 patients, 36 had a galectin-3 value above the cut-off value of 17.8 ng/ml. These patients had significantly higher systolic pulmonary artery and capillary wedge pressures. The hazard ratio in patients with galectin-3 > 17.8 ng/ml was 3.36 (95 % confidence interval, CI: 1.47 - 7.69; p = 0.004) for the VARC 30-day safety endpoint, 5.12 (95 % CI: 2.10 - 12.47; p < 0.001) for one-year cardiovascular events, and 4.48 (95 % CI: 1.56 - 12.91; p = 0.005) for all-cause mortality. This prediction remained stable even after adjusting for possible confounders including age, sex, glomerular filtration rate, and NT-proBNP. Furthermore, the prediction was even more valuable when combining galectin-3 with NT-proBNP for cardiovascular events (HR = 6.39; CI: 2.87-23.89; p < 0.001) and all-cause mortality (HR = 8.28; CI: 2.01-23.59; p < 0.001). Conclusions: Elevated galectin-3 levels are independently associated with adverse outcome after TAVI. Combining galectin-3 with NT-proBNP provides additive predictive value of risk stratification.