Association of Galectin-3 and Soluble ST2, and Their Changes, with Echocardiographic Parameters and Development of Heart Failure after ST-Segment Elevation Myocardial Infarction

Agata Tymińska, Agnieszka Kapłon-Cieślicka, Krzysztof Ozierański, Monika Budnik, Anna Wancerz, Piotr Sypień, Michał Peller, Paweł Balsam, Grzegorz Opolski, Krzysztof J Filipiak, Agata Tymińska, Agnieszka Kapłon-Cieślicka, Krzysztof Ozierański, Monika Budnik, Anna Wancerz, Piotr Sypień, Michał Peller, Paweł Balsam, Grzegorz Opolski, Krzysztof J Filipiak

Abstract

Purpose: To investigate the association of galectin-3 (Gal-3) and soluble ST2 (sST2) and their follow-up changes with the development of heart failure (HF) and echocardiographic parameters of HF (ejection fraction, atrial and ventricular size, left ventricular hypertrophy, e', and E/e') in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI).

Methods: A prospective, observational study, BIOSTRAT (Biomarkers for Risk Stratification After STEMI), enrolled 117 patients between October 2014 and April 2017. Gal-3 and sST2 serum collection and echocardiography were performed twice (during index hospitalization and on a control visit at one-year follow-up). The primary endpoint was HF onset at one-year follow-up. Secondary assessments included associations of biomarker concentration with echocardiographic indices of systolic and diastolic dysfunction at baseline and at one year.

Results: Mean baseline concentrations of Gal-3 and sST2 (7.5 and 26.4 ng/mL, respectively) were significantly increased at one-year follow-up (8.5 ng/mL and p < 0.001 and 31.4 ng/mL and p = 0.001, respectively). Patients who reached the primary endpoint (50 patients (48%)) had significantly higher baseline concentrations of both biomarkers and a higher Gal-3 level at one year compared to patients who did not. Both Gal-3 and sST2 were predictors of the primary endpoint in univariate logistic regression analysis, but only Gal-3 remained significant in multivariate analysis. There was no clear association between both biomarkers and echocardiographic parameters.

Conclusions: Baseline, but not one-year, changes of Gal-3 and sST2 concentrations may be useful for risk stratification after STEMI. However, only Gal-3 was the independent predictor of HF development at one-year observation. This trial is registered with NCT03735719.

Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this article.

Copyright © 2019 Agata Tymińska et al.

Figures

Figure 1
Figure 1
Flow chart of patient enrolment in the current analysis. HF: heart failure; pPCI: primary percutaneous coronary intervention; STEMI: ST-segment elevation myocardial infarction.
Figure 2
Figure 2
Changes∗ in biomarker concentrations. ∗Changes were calculated as the one-year level minus the baseline level of each biomarker.

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