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Gal-3 y ST2 como biomarcadores: un paso al frente en el pronóstico de la Insuficiencia Cardíaca

2021Journal article Open access
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dc.contributor.authorBarbosa, M
dc.contributor.authorMatos, A
dc.contributor.authorBicho, M
dc.contributor.authorFalcão, LM
dc.date.accessioned2021-11-02T21:27:44Z
dc.date.available2021-11-02T21:27:44Z
dc.date.issued2021
dc.description.abstractAims: The American College of Cardiology (ACA)/ American Heart Association (AHA) granted Galectin-3 (Gal-3) and Suppression of Tumorigenicity 2 (ST2) evaluation a class II recommendation for HF prognosis, as an adjunctive to conventional clinical risk factors and natriuretic peptides dosing in 2013. However, in Europe this endorsement is not valid. The purpose of this study was to study the association of Gal-3 and ST2 collected at-admission with early (defined as the period of 90 days post-discharge) rehospitalization and overall mortality, and end of follow-up overall mortality in HF patients. Additionally, aminoterminal B-type natriuretic peptide (NT-proBNP) at admission was considered to test if a multi-marker strategy could yield supplementary information. Material and Methods: Gal-3, ST2 and NT-proBNP were assessed in patients hospitalized with acute decompensated HF in class III or IV of New York Heart Association (NYHA). Univariate Cox proportional hazard model was used to assess the relationship between variables and outcomes. Since there are no standardized cut-offs for Gal-3 and ST2, the multiclass Area Under the Curve Receiver-Operator Characteristic (AUCROC) as defined by Hand and Till was used to evaluate the overall performance of each biomarker as a predictor of the outcomes. Results: We followed 65 patients for a median of 13.7 (Q1-Q3 6.7-18.9) months. Gal-3 correlated with short-term rehospitalization (HR: 9.886, 95% CI: 2.027-48.214, P-value=0.005), short-term mortality (HR: 13.731, 95% CI: 1.650-114.276, P value=0.015) and end of follow-up mortality (HR: 4.492, 95% CI: 1.594-12.656, P-value=0.004). The association of elevated NT-proBNP determinations increased the risk of short-term rehospitalization (HR: 11.985, 95% CI: 1.962-73.218, P value=0.007) and end of follow-up mortality (HR: 78.025, 95% CI: 7.592-801.926, P-value<0.001). ST2 correlated with end of follow-up mortality (HR: 4.846, 95% CI: 1.396-16.825, P-value=0.013). The risk further increased if NT-proBNP (HR: 5.953, 95% CI: 1.683- 21.055, P-value=0.006) or Gal-3 determinations (HR: 6.209, 95% CI: 2.393-16.114, P-value<0.001) were added. Conclusions: Elevated Gal-3 concentrations correlated with short-term rehospitalization, short-term mortality and end of follow-up mortality; whereas ST2 prognosticated end of follow-up mortality. Collective analysis with elevated NT-proBNP values further increased the outcomes’ risk. These results corroborate the assumption that promising novel biomarkers Gal-3 and ST2 could be valuable for HF risk stratification. We highlight that a multi-marker strategy added information, as a synergism between myocardial fibrosis biomarkers and the myocardial stretch peptide was observed.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationGalicia Clin. 2021; 82-3: 146-151pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.26/37869
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectBiomarcadorespt_PT
dc.subjectGalectina 3pt_PT
dc.subjectInsuficiência Cardíacapt_PT
dc.subjectProteína 1 Semelhante a Receptor de Interleucina-1pt_PT
dc.subjectPrognósticopt_PT
dc.subjectBiomarkerspt_PT
dc.subjectGalectin 3pt_PT
dc.subjectHeart Failurept_PT
dc.subjectInterleukin-1 Receptor-Like 1 Proteinpt_PT
dc.subjectPrognosispt_PT
dc.titleGal-3 y ST2 como biomarcadores: un paso al frente en el pronóstico de la Insuficiencia Cardíacapt_PT
dc.title.alternativeGal-3 and ST2 Biomarkers - A Step Forward in Heart Failure Prognosticationpt_PT
dc.typejournal article
dspace.entity.typePublication
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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