Study on correlation of serum levels of galectin-3, N-terminal pro brain natriuretic peptide, brain natriuretic peptide and c-reactive protein with mortality during 30-day hospitalization in patients with decompensated acute attack of chronic heart failure

Abstract

Objective To analyze the correlation of serum levels of galectin-3(Gal-3), N-terminal pro brain natriuretic peptide(NT-proBNP), brain natriuretic peptide(BNP)and C reactive protein(CRP)with prognosis of patients with decompensated acute attack of chronic heart failure(DAACHF), and to evaluate its significance in predicting mortality during 30-day hospitalization. Methods 103 DAACHF patients admitted in Peking University First Hospital and Capital Medical University-affiliated Beijing Anzhen Hospital Department of Cardiology from July 2012 to June 2015 were divided into death group(n=53, died of DAACHF)and survival group(n=50)matched for age, gender, cardiac function during 30-day hospitalization.Serum levels of Gal-3, NT-proBNP, BNP, CRP and the Minnesota Living with Heart Failure Questionnaire(MLHFQ)were retrospectively collected and compared on the first hospital day and 3 days, 7 days, 14 days after treatment.After 7 days of treatment, the serum levels of four markers were correlated with MLHFQ.The areas under the receiver operating characteristic(ROC)curve were used for estimating efficiencies of serum levels of four markers in predicting DAACHF patients' mortality during 30-day hospitalization. Results With prolonged treatment, the scores of Gal-3, NT-proBNP, BNP, CRP and MLHFQ were gradually increased in the group of death, and gradually decreased in survival group.The scores of Gal-3, NT-proBNP, BNP, CRP and MLHFQ were higher in the death group than in control group(P<0.05)at the day of hospital admission and at 3 days, 7 days and 14 days after treatment(P<0.05). On 7 days after treatment, Gal-3, NT-proBNP, BNP, and CRP were positively correlated with MLHFQ score(r=0.748, 0.730, 0.6872, all P<0.01), and the areas under ROC curves predicting performance for mortality during 30-day hospitalization were 0.943, 0.907, 0.876, 0.867, 0.913 for Gal-3, NT-proBNP, BNP, CRP and MLHFQ score, respectively, all P<0.01). Conclusions Serum levels of Gal-3, NT-proBNP, BNP and CRP were positively correlated with adverse prognosis for DAACHF patients, and they may be predictors of mortality during 30-day hospitalization with sequence effect of Gal-3>NT-proBNP>BNP>CRP.And their joint monitoring is better in predicting the prognosis of patients with heart failure. Key words: Heart failure; Galectin-3; Natriuretic peptide, brain; C-reactive protein