The predictive value of galectin-3 for mortality and cardiovascular events in the controlled rosuvastatin multinational trial in heart failure (CORONA)

Gullestad, L., Ueland, T., Kjekshus, J., Nymo, S.H., Hulthe, J., Muntendam, P., McMurray, J.J.V. , Wikstrand, J. and Aukrust, P. (2012) The predictive value of galectin-3 for mortality and cardiovascular events in the controlled rosuvastatin multinational trial in heart failure (CORONA). American Heart Journal, 164(6), pp. 878-883. (doi: 10.1016/j.ahj.2012.08.021)

Abstract

Background Galectin-3 is a new biomarker involved in inflammation and fibrogenesis and could therefore contribute to myocardial remodeling. We examined the prognostic value of baseline galectin-3 in a substudy involving approximately 30% of participants in the CORONA study. Methods Patients (n = 1462) aged N60 years with systolic, ischemic heart failure (HF) were randomized to 10 mg/d rosuvastatin or placebo. The primary composite end point was cardiovascular death, nonfatal myocardial infarction, or stroke (n = 408). Results In the unadjusted analysis, galectin-3 was associated with all end points considered, except hospitalization for worsening of HF. In multivariable analyses, adjusting for other clinical and biochemical predictor variables, galectin-3 was significantly associated with the primary end point (hazard ratio [HR] 1.53 [1.10-2.12], P = .011) as well as all-cause (HR 1.61 [1.20-2.29], P = .002) and cardiovascular mortality (HR 1.70 [1.19-2.42], P = .003), sudden death (HR 1.83 [1.14-2.94], P = .012), and the coronary end point (HR 1.48 [1.03-2.12], P = .035). However, when N-terminal pro–brain natriuretic peptide was added to the model, galectin-3 association with the end points was markedly attenuated and no longer significant. Conclusions Galectin-3 is not associated with outcome in older patients with advanced chronic systolic HF of ischemic etiology when adjusting for N-terminal pro–brain natriuretic peptide and may therefore have limited use in the prognostication of elderly patients with systolic HF in clinical practice.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McMurray, Professor John
• Authors: Gullestad, L., Ueland, T., Kjekshus, J., Nymo, S.H., Hulthe, J., Muntendam, P., McMurray, J.J.V., Wikstrand, J., and Aukrust, P.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: American Heart Journal
• ISSN: 0002-8703