Serial galectin-3 and future cardiovascular disease in the general population

A Rogier van der Velde; Wouter C Meijers; Jennifer E Ho; Frank P Brouwers; Michiel Rienstra; Stephan J L Bakker; Anneke C Muller Kobold; Dirk J van Veldhuisen; Wiek H van Gilst; Pim van der Harst; Rudolf A de Boer

doi:10.1136/heartjnl-2015-308975

Serial galectin-3 and future cardiovascular disease in the general population

A Rogier van der Velde, Wouter C Meijers, Jennifer E Ho, Frank P Brouwers, Michiel Rienstra, Stephan J L Bakker, Anneke C Muller Kobold, Dirk J van Veldhuisen, Wiek H van Gilst, Pim van der Harst, Rudolf A de Boer

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Lifetime risk for cardiovascular (CV) disease is high but predicting incident events on an individual level remains difficult. Single measurements of galectin-3, a marker of tissue fibrosis, predict mortality and new-onset heart failure (HF). Persistently elevated levels may indicate a clinically silent disease process.

OBJECTIVES: Our aim was to establish the value of serial galectin-3 measurements to predict CV outcomes in the general population.

METHODS: Plasma galectin-3 was measured in the Prevention of REnal and Vascular ENd-stage Disease (PREVEND) study at baseline and after ∼4 years. Changes in serial galectin-3 were expressed as categorical changes or absolute change from baseline and were related to subsequent outcome.

RESULTS: Serial galectin-3 was measured in 5958 subjects (mean age 49±12 years; 49% female). The median duration of follow-up was 8.3 years. Persistently elevated galectin-3 (defined as highest quartile at baseline and highest quartile during visit 2, n=757 subjects) was associated with a higher risk for new-onset HF, CV mortality, all-cause mortality, new-onset atrial fibrillation and CV events, compared with subjects with non-persistently elevated galectin-3. After multivariable adjustments for baseline characteristics, serial galectin-3 remained an independent predictor of new-onset HF (HR 1.85 (1.10-3.13); p=0.02) but not for other outcomes. Serial measurements provided more accurate prognostic value to predict new-onset HF, compared with a single baseline measurement (Harrell's C: 0.72 (0.68-0.75) vs 0.68 (0.65-0.72); p=0.002, respectively) with significant net reclassification.

CONCLUSIONS: Persistently elevated galectin-3 predicts new-onset HF after adjustment for covariates, and serial measurements provide more accurate prognostic information compared with single determination of galectin-3. This may help to identify individuals who are at risk for incident HF and might provide a measure to monitor interventions.

Original language	English
Pages (from-to)	1134-41
Number of pages	8
Journal	Heart (British Cardiac Society)
Volume	102
Issue number	14
DOIs	https://doi.org/10.1136/heartjnl-2015-308975
Publication status	Published - 15 Jul 2016
Externally published	Yes

Keywords

Adult
Aged
Biomarkers/blood
Blood Proteins
Chi-Square Distribution
Enzyme-Linked Immunosorbent Assay
Female
Galectin 3/blood
Galectins
Heart Failure/blood
Humans
Incidence
Linear Models
Male
Middle Aged
Multivariate Analysis
Netherlands/epidemiology
Predictive Value of Tests
Prognosis
Risk Factors
Time Factors
Up-Regulation

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10.1136/heartjnl-2015-308975

Cite this

van der Velde, A. R., Meijers, W. C., Ho, J. E., Brouwers, F. P., Rienstra, M., Bakker, S. J. L., Muller Kobold, A. C., van Veldhuisen, D. J., van Gilst, W. H., van der Harst, P., & de Boer, R. A. (2016). Serial galectin-3 and future cardiovascular disease in the general population. Heart (British Cardiac Society), 102(14), 1134-41. https://doi.org/10.1136/heartjnl-2015-308975

@article{c000978d501c4b7a996ba2cf87345063,

title = "Serial galectin-3 and future cardiovascular disease in the general population",

abstract = "BACKGROUND: Lifetime risk for cardiovascular (CV) disease is high but predicting incident events on an individual level remains difficult. Single measurements of galectin-3, a marker of tissue fibrosis, predict mortality and new-onset heart failure (HF). Persistently elevated levels may indicate a clinically silent disease process.OBJECTIVES: Our aim was to establish the value of serial galectin-3 measurements to predict CV outcomes in the general population.METHODS: Plasma galectin-3 was measured in the Prevention of REnal and Vascular ENd-stage Disease (PREVEND) study at baseline and after ∼4 years. Changes in serial galectin-3 were expressed as categorical changes or absolute change from baseline and were related to subsequent outcome.RESULTS: Serial galectin-3 was measured in 5958 subjects (mean age 49±12 years; 49% female). The median duration of follow-up was 8.3 years. Persistently elevated galectin-3 (defined as highest quartile at baseline and highest quartile during visit 2, n=757 subjects) was associated with a higher risk for new-onset HF, CV mortality, all-cause mortality, new-onset atrial fibrillation and CV events, compared with subjects with non-persistently elevated galectin-3. After multivariable adjustments for baseline characteristics, serial galectin-3 remained an independent predictor of new-onset HF (HR 1.85 (1.10-3.13); p=0.02) but not for other outcomes. Serial measurements provided more accurate prognostic value to predict new-onset HF, compared with a single baseline measurement (Harrell's C: 0.72 (0.68-0.75) vs 0.68 (0.65-0.72); p=0.002, respectively) with significant net reclassification.CONCLUSIONS: Persistently elevated galectin-3 predicts new-onset HF after adjustment for covariates, and serial measurements provide more accurate prognostic information compared with single determination of galectin-3. This may help to identify individuals who are at risk for incident HF and might provide a measure to monitor interventions.",

keywords = "Adult, Aged, Biomarkers/blood, Blood Proteins, Chi-Square Distribution, Enzyme-Linked Immunosorbent Assay, Female, Galectin 3/blood, Galectins, Heart Failure/blood, Humans, Incidence, Linear Models, Male, Middle Aged, Multivariate Analysis, Netherlands/epidemiology, Predictive Value of Tests, Prognosis, Risk Factors, Time Factors, Up-Regulation",

author = "{van der Velde}, {A Rogier} and Meijers, {Wouter C} and Ho, {Jennifer E} and Brouwers, {Frank P} and Michiel Rienstra and Bakker, {Stephan J L} and {Muller Kobold}, {Anneke C} and {van Veldhuisen}, {Dirk J} and {van Gilst}, {Wiek H} and {van der Harst}, Pim and {de Boer}, {Rudolf A}",

note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/",

year = "2016",

month = jul,

day = "15",

doi = "10.1136/heartjnl-2015-308975",

language = "English",

volume = "102",

pages = "1134--41",

journal = "Heart (British Cardiac Society)",

issn = "1355-6037",

publisher = "BMJ Publishing Group",

number = "14",

}

TY - JOUR

T1 - Serial galectin-3 and future cardiovascular disease in the general population

AU - van der Velde, A Rogier

AU - Meijers, Wouter C

AU - Ho, Jennifer E

AU - Brouwers, Frank P

AU - Rienstra, Michiel

AU - Bakker, Stephan J L

AU - Muller Kobold, Anneke C

AU - van Veldhuisen, Dirk J

AU - van Gilst, Wiek H

AU - van der Harst, Pim

AU - de Boer, Rudolf A

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

PY - 2016/7/15

Y1 - 2016/7/15

N2 - BACKGROUND: Lifetime risk for cardiovascular (CV) disease is high but predicting incident events on an individual level remains difficult. Single measurements of galectin-3, a marker of tissue fibrosis, predict mortality and new-onset heart failure (HF). Persistently elevated levels may indicate a clinically silent disease process.OBJECTIVES: Our aim was to establish the value of serial galectin-3 measurements to predict CV outcomes in the general population.METHODS: Plasma galectin-3 was measured in the Prevention of REnal and Vascular ENd-stage Disease (PREVEND) study at baseline and after ∼4 years. Changes in serial galectin-3 were expressed as categorical changes or absolute change from baseline and were related to subsequent outcome.RESULTS: Serial galectin-3 was measured in 5958 subjects (mean age 49±12 years; 49% female). The median duration of follow-up was 8.3 years. Persistently elevated galectin-3 (defined as highest quartile at baseline and highest quartile during visit 2, n=757 subjects) was associated with a higher risk for new-onset HF, CV mortality, all-cause mortality, new-onset atrial fibrillation and CV events, compared with subjects with non-persistently elevated galectin-3. After multivariable adjustments for baseline characteristics, serial galectin-3 remained an independent predictor of new-onset HF (HR 1.85 (1.10-3.13); p=0.02) but not for other outcomes. Serial measurements provided more accurate prognostic value to predict new-onset HF, compared with a single baseline measurement (Harrell's C: 0.72 (0.68-0.75) vs 0.68 (0.65-0.72); p=0.002, respectively) with significant net reclassification.CONCLUSIONS: Persistently elevated galectin-3 predicts new-onset HF after adjustment for covariates, and serial measurements provide more accurate prognostic information compared with single determination of galectin-3. This may help to identify individuals who are at risk for incident HF and might provide a measure to monitor interventions.

AB - BACKGROUND: Lifetime risk for cardiovascular (CV) disease is high but predicting incident events on an individual level remains difficult. Single measurements of galectin-3, a marker of tissue fibrosis, predict mortality and new-onset heart failure (HF). Persistently elevated levels may indicate a clinically silent disease process.OBJECTIVES: Our aim was to establish the value of serial galectin-3 measurements to predict CV outcomes in the general population.METHODS: Plasma galectin-3 was measured in the Prevention of REnal and Vascular ENd-stage Disease (PREVEND) study at baseline and after ∼4 years. Changes in serial galectin-3 were expressed as categorical changes or absolute change from baseline and were related to subsequent outcome.RESULTS: Serial galectin-3 was measured in 5958 subjects (mean age 49±12 years; 49% female). The median duration of follow-up was 8.3 years. Persistently elevated galectin-3 (defined as highest quartile at baseline and highest quartile during visit 2, n=757 subjects) was associated with a higher risk for new-onset HF, CV mortality, all-cause mortality, new-onset atrial fibrillation and CV events, compared with subjects with non-persistently elevated galectin-3. After multivariable adjustments for baseline characteristics, serial galectin-3 remained an independent predictor of new-onset HF (HR 1.85 (1.10-3.13); p=0.02) but not for other outcomes. Serial measurements provided more accurate prognostic value to predict new-onset HF, compared with a single baseline measurement (Harrell's C: 0.72 (0.68-0.75) vs 0.68 (0.65-0.72); p=0.002, respectively) with significant net reclassification.CONCLUSIONS: Persistently elevated galectin-3 predicts new-onset HF after adjustment for covariates, and serial measurements provide more accurate prognostic information compared with single determination of galectin-3. This may help to identify individuals who are at risk for incident HF and might provide a measure to monitor interventions.

KW - Adult

KW - Aged

KW - Biomarkers/blood

KW - Blood Proteins

KW - Chi-Square Distribution

KW - Enzyme-Linked Immunosorbent Assay

KW - Female

KW - Galectin 3/blood

KW - Galectins

KW - Heart Failure/blood

KW - Humans

KW - Incidence

KW - Linear Models

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Netherlands/epidemiology

KW - Predictive Value of Tests

KW - Prognosis

KW - Risk Factors

KW - Time Factors

KW - Up-Regulation

U2 - 10.1136/heartjnl-2015-308975

DO - 10.1136/heartjnl-2015-308975

M3 - Article

C2 - 27084804

SN - 1355-6037

VL - 102

SP - 1134

EP - 1141

JO - Heart (British Cardiac Society)

JF - Heart (British Cardiac Society)

IS - 14

ER -

Serial galectin-3 and future cardiovascular disease in the general population

Abstract

Keywords

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