Serial measurement of galectin-3 in patients with chronic heart failure: results from the ProBNP Outpatient Tailored Chronic Heart Failure Therapy (PROTECT) study

Galectin-3 is a prognostic heart failure (HF) biomarker that may mediate cardiac fibrosis. We examined the value of serial galectin-3 measurement for prognosis and response to therapy in chronic HF. A total of 151 subjects with LV systolic dysfunction (LVSD) were followed through 908 visits over 10 3 months. The amount of time spent with a galectin-3 level 20.0 ng/mL and changes between baseline and subsequent values were considered across visits, and used to assess risk for adverse cardiovascular (CV) events and associations with LV remodelling. Medication effects on galectin-3 were examined. Median galectin-3 values at baseline, 3 months, and 6 months were higher in patients with CV events (21.7 vs. 18.4 ng/mL, P 0.03; 21.7 vs. 16.5 ng/mL, P 0.03; 23.2 vs. 16.0 ng/mL, P 0.007). Galectin-3 concentration changed in 35.2 of subjects during study procedures; time spent at 20.0 ng/mL was significantly associated with a lower rate of CV events, independently predicted fewer CV events even adjusted for relevant variables including study allocation, NT-proBNP, and renal function [odds ratio (OR) 0.90; P 0.05], and predicted increase in LV ejection fraction (OR 1.20; P 0.04). Serial galectin-3 measurement at 6 months added prognostic value beyond the baseline level (P 0.02). There were no significant effects of medications on galectin-3 levels. In chronic HF due to LVSD, serial galectin-3 measurement adds incremental prognostic information and predicts LV remodelling. In this study, HF therapies had no clear effects on galectin-3 levels.