Abstract TP513: Plasma Galectin-3 Predicts Functional Outcome After Acute Ischemic Stroke

Abstract

Introduction: Galectin-3 (Gal-3) is a member of the beta-galactoside-binding protein family that has been implicated in cardiovascular disease and stroke. We sought to determine if baseline Gal-3 predicts functional outcome after acute ischemic stroke, and to compare its performance relative to several other prognostic biomarkers. Methods: We measured plasma Gal-3, soluble ST2 (sST2), and fatty acid binding protein 4 (FABP4) in 383 patients who presented with acute ischemic stroke and were enrolled in a two-center biomarker study. Additional analyses that include copeptin are currently underway. Functional outcome was assessed at 3 months with the modified Rankin Scale (mRS), with good outcome defined as mRS 0-2, and poor outcome defined as mRS 3-6. The relationships between each marker and outcome were evaluated using univariate and multivariate logistic regression. Results: Median admission Gal-3 level was 7.4 ng/mL [IQR 5.2-11.7], median sST2 was 41.3 ng/mL [IQR 30.1-57.3] and median FABP4 was 37.8 ng/mL [21.2-57.1] in 383 patients (mean age 69+/- 15 years; 41.5% women). In univariate analysis, each biomarker predicted poor outcome (Gal-3: OR 1.8, 95% CI 1.4 - 2.4, p<0.001, AUC=0.673; sST2: OR 1.6, 95% CI 1.2 - 2.0, p<0.001, AUC=0.612; FABP4: OR 1.9, 95% CI 1.4 - 2.6, p<0.001, AUC=0.592). After adjustment for age, sex, and NIHSS, Gal-3 remained an independent predictor of poor outcome (OR 1.5, 95% CI 1.1 - 2.0, p=0.019), but the other markers did not. However, both Gal-3 and sST2 were independent predictors of death at 3 months (Gal-3: OR 1.9, 95% CI 1.2 - 3.3, p=0.009, AUC=0.724; sST2: OR 1.7, 95% CI 1.1 - 2.6, p=0.027, AUC=0.689). Conclusion: Among three previously validated biomarkers, plasma Gal-3 level predicted 3-month functional outcome, and Gal-3 and sST2 predicted mortality. Replication in a second cohort is planned.