Prognostic significance of serum galectin-3 in predicting cardiovascular outcomes after percutaneous coronary intervention with drug-eluting stents

Abstract

Background: Galectin-3 is a well-established biomarker on the predictor of cardiovascular events in patients with heart failure. Its pathophysiologic association with inflammation, cell proliferation, and fibrogenesis may implicate serum galectin-3 as a predictor of clinical outcomes in coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES). The aim of this study was to examine the prognostic value of the galectin-3 level in patients with CAD who underwent PCI with DES. Methods: A total of 939 patients undergoing successful PCI with DES were consecutively enrolled between January 2007 and December 2009. The serum galectin-3 level was measured, classified into two groups according to the median galectin-3 level (9.52 ng/ml, interquartile range 7.31–12.81), and compared with the composite of all-cause mortality, non-fatal myocardial infarction (MI), and stroke. Results: The median follow-up duration was 997 days (interquartile range 766–1,264 days). The high galectin-3 group had a significantly higher incidence of all-cause mortality, cardiac mortality, and composite of all-cause mortality, non-fatal MI, and stroke. High galectin-3 was a significant independent predictor of the composite of all-cause mortality, non-fatal MI, and stroke (adjusted hazard ratio 1.670, 95% confidence interval 1.014–2.751, p = 0.044). The addition of the serum galectin-3 level to the conventional clinical risk model improves the model discrimination (C-statistic = 0.694–0.786, p for difference < 0.01), reclassification [continuous net classification improvement (0.297, p < 0.01) and integrated discrimination improvement (0.064, p < 0.01)]. Conclusion: Our data suggest that serum galectin-3 is an independent predictor of cardiovascular events in patients undergoing PCI with DES.