Abstract
Purpose To investigate the association of galectin-3 (Gal-3) and soluble ST2 (sST2) and their follow-up changes with the development of heart failure (HF) and echocardiographic parameters of HF (ejection fraction, atrial and ventricular size, left ventricular hypertrophy, e′, and E/e′) in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods A prospective, observational study, BIOSTRAT (Biomarkers for Risk Stratification After STEMI), enrolled 117 patients between October 2014 and April 2017. Gal-3 and sST2 serum collection and echocardiography were performed twice (during index hospitalization and on a control visit at one-year follow-up). The primary endpoint was HF onset at one-year follow-up. Secondary assessments included associations of biomarker concentration with echocardiographic indices of systolic and diastolic dysfunction at baseline and at one year. Results Mean baseline concentrations of Gal-3 and sST2 (7.5 and 26.4 ng/mL, respectively) were significantly increased at one-year follow-up (8.5 ng/mL and p < 0.001 and 31.4 ng/mL and p = 0.001, respectively). Patients who reached the primary endpoint (50 patients (48%)) had significantly higher baseline concentrations of both biomarkers and a higher Gal-3 level at one year compared to patients who did not. Both Gal-3 and sST2 were predictors of the primary endpoint in univariate logistic regression analysis, but only Gal-3 remained significant in multivariate analysis. There was no clear association between both biomarkers and echocardiographic parameters. Conclusions Baseline, but not one-year, changes of Gal-3 and sST2 concentrations may be useful for risk stratification after STEMI. However, only Gal-3 was the independent predictor of HF development at one-year observation. This trial is registered with NCT03735719.
Highlights
Acute myocardial infarction (AMI) initiates left ventricular remodeling (LVR) and may lead to the development of heart failure (HF) [1]
The aim of this study was to investigate the association of Gal-3 and soluble ST2 (sST2) concentrations and their changes at one-year follow-up with the development of clinically overt HF and echocardiographic indices of HF (left ventricular (LV) ejection fraction (LVEF), atrial and ventricular size, LV hypertrophy based on LV mass index (LVMI), diastolic tissue velocities at the mitral annulus (e′), and E/e′ ratio) in patients after ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention
The main finding of our study is that baseline Gal-3 and sST2 presented potential clinical utility in predicting HF development at one year among patients admitted primarily due to STEMI treated with primary percutaneous coronary intervention (pPCI)
Summary
Acute myocardial infarction (AMI) initiates left ventricular remodeling (LVR) and may lead to the development of heart failure (HF) [1]. In addition to natriuretic peptides, circulating galectin-3 (Gal-3) and soluble interleukin-1 receptor-like 1 (sST2) are independent markers of adverse outcomes in HF [4,5,6,7,8,9,10]. These two biomarkers have been already recommended for an additive risk stratification
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