Abstract
Background: Acute myocardial infarction (AMI) survivors are at risk of major adverse cardiac events and their risk stratification is a prerequisite to tailored therapeutic approaches. Biomarkers could be of great utility in this setting. Methods: We sought to evaluate the utility of the combined assessment of Galectin 3 (Gal-3) and Galectin 3 binding protein (Gal-3bp) for post-AMI risk stratification in a large, consecutive population of AMI patients. The primary outcomes were: Recurrent angina/AMI and all-cause mortality at 12 months after the index event. Results: In total, 469 patients were included. The median Gal-3bp was 9.1 μg/mL (IQR 5.8–13.5 μg/mL), while median Gal-3 was 9.8 ng/mL (IQR 7.8–12.8 ng/mL). During the 12 month follow-up, 34 patients died and 41 had angina pectoris/reinfarction. Gal-3 was associated with all-cause mortality, while Gal-3bp correlated with the risk of angina/myocardial infarction even when corrected for other significant covariates. The final multivariable model for mortality prediction included patients’ age, left ventricular ejection fraction (LVEF), Gal-3, and renal function. The ROC curve estimated for this model has an area under the curve (AUC) of 0.84 (95%CI 0.78–0.9), which was similar to the area under the ROC curve obtained using the GRACE score 1-year mortality. Conclusions: The integrated assessment of Gal-3 and Gal-3bp could be helpful in risk stratification after AMI.
Highlights
Coronary heart disease is still the leading cause of death worldwide [1]
We aimed to determine if Galectin 3 and Galectin 3 binding protein tested together could be useful for event prediction in a large, unselected consecutive population of patients affected by myocardial infarction
60% of them presented with ST-segment elevation acute myocardial infarction
Summary
Coronary heart disease is still the leading cause of death worldwide [1]. with the adoption of coronary revascularization therapy and secondary prevention measures, the survival rates after acute ischemic events have increased, and, the prevalence of patients surviving acute myocardial infarction (AMI) is growing [2]. Patients that experienced an acute ischemic coronary event are at risk of major adverse cardiac events, such as cardiac death or reinfarction, which is a strong independent predictor of mortality [3]. Risk stratification of AMI patients is a prerequisite to optimize patient-tailored therapeutic approaches in order to improve prognosis. To fulfil this task, biomarkers could be of great utility, since they could provide objective information that is understood. Acute myocardial infarction (AMI) survivors are at risk of major adverse cardiac events and their risk stratification is a prerequisite to tailored therapeutic approaches. Gal-3 was associated with all-cause mortality, while Gal-3bp correlated with the risk of angina/myocardial infarction even when corrected for other significant covariates. Conclusions: The integrated assessment of Gal-3 and Gal-3bp could be helpful in risk stratification after AMI
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