Galectin-3 in Patients from 2012-2020: A Prognostic Biomarker of Left Ventricular Assist Device Post Implantation Outcomes

Abstract

Purpose Galectin-3 is a novel biomarker that has been used to risk stratify patients with heart failure. Elevated levels with values greater than 25.9 ng/mL are linked with poor outcomes and higher cardiovascular risk, however, outcomes in Left Ventricular Assist Device (LVAD) patients have not been well explored. We sought to investigate the relationship between Galectin-3 and outcomes in the LVAD population. Methods From 2012 to 2020, 249 patients with heart failure at our institution had lab values collected for Galectin-3. Among them, 171 patients underwent LVAD implantation. Lab and hemodynamic values, including Galectin-3, Creatinine, and PAPI, were collected for all patients prior to LVAD implant. Post-LVAD outcomes, including right ventricular failure (RVF), time on inotropes, need for right ventricular assist device (RVAD), length of ICU stay, and mortality were collected. Results There was no significant correlation between age, BMI, BSA and Galectin-3 (Table 1). Patients who experienced RVF (n=59) had a higher mean Galectin-3 compared to those who did not (n=112), with 30.9 ng/mL ± 15.21 compared to 24.9 ng/mL ± 10.7 (p=0.004). Those who received an RVAD (n=18) had higher Galectin-3 levels with mean 28.8 ng/mL ± 12.87 than those that did not (n=153) with mean 26.9 ng/mL ± 12.89 (p=0.558). Galectin-3 was positively correlated with inotrope duration (r=0.306, p=0.001), Creatinine (r=0.278, p=0.001) and length of ICU stay (r=0.191, p=0.022). Galectin-3 levels in patients who died (n=73) were higher than in those who did not (n=98), with a mean of 28.95 ng/mL ± 13.25 compared to 25.73 ng/mL ± 12.38 (p=0.11). Galectin-3 was negatively correlated to PAPI (r=-0.177, p=0.05), but was not significantly correlated to other hemodynamic parameters. Conclusion The Galectin-3 biomarker can be used as a predictor of post-LVAD implantation outcomes, elevated levels being associated with RVF, longer time on inotropes, increased length of ICU stay, decreased PAPI, and elevated creatinine. Galectin-3 is a novel biomarker that has been used to risk stratify patients with heart failure. Elevated levels with values greater than 25.9 ng/mL are linked with poor outcomes and higher cardiovascular risk, however, outcomes in Left Ventricular Assist Device (LVAD) patients have not been well explored. We sought to investigate the relationship between Galectin-3 and outcomes in the LVAD population. From 2012 to 2020, 249 patients with heart failure at our institution had lab values collected for Galectin-3. Among them, 171 patients underwent LVAD implantation. Lab and hemodynamic values, including Galectin-3, Creatinine, and PAPI, were collected for all patients prior to LVAD implant. Post-LVAD outcomes, including right ventricular failure (RVF), time on inotropes, need for right ventricular assist device (RVAD), length of ICU stay, and mortality were collected. There was no significant correlation between age, BMI, BSA and Galectin-3 (Table 1). Patients who experienced RVF (n=59) had a higher mean Galectin-3 compared to those who did not (n=112), with 30.9 ng/mL ± 15.21 compared to 24.9 ng/mL ± 10.7 (p=0.004). Those who received an RVAD (n=18) had higher Galectin-3 levels with mean 28.8 ng/mL ± 12.87 than those that did not (n=153) with mean 26.9 ng/mL ± 12.89 (p=0.558). Galectin-3 was positively correlated with inotrope duration (r=0.306, p=0.001), Creatinine (r=0.278, p=0.001) and length of ICU stay (r=0.191, p=0.022). Galectin-3 levels in patients who died (n=73) were higher than in those who did not (n=98), with a mean of 28.95 ng/mL ± 13.25 compared to 25.73 ng/mL ± 12.38 (p=0.11). Galectin-3 was negatively correlated to PAPI (r=-0.177, p=0.05), but was not significantly correlated to other hemodynamic parameters. The Galectin-3 biomarker can be used as a predictor of post-LVAD implantation outcomes, elevated levels being associated with RVF, longer time on inotropes, increased length of ICU stay, decreased PAPI, and elevated creatinine.