Prognostic value of the interaction between galectin-3 and antigen carbohydrate 125 in acute heart failure

• Published in: PloS one Vol. 10; no. 4; p. e0122360
• Main Authors: Núñez, Julio, Rabinovich, Gabriel A, Sandino, Justo, Mainar, Luis, Palau, Patricia, Santas, Enrique, Villanueva, Maria Pilar, Núñez, Eduardo, Bodí, Vicent, Chorro, Francisco J, Miñana, Gema, Sanchis, Juan
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13.04.2015; Public Library of Science (PLoS)
• Subjects: Aged; Aged, 80 and over; Antigens; Arthritis; Biomarkers; Biomarkers - blood; CA-125 Antigen - blood; Carbohydrates; Cardiology; Cell adhesion & migration; Cytokines; Female; Follow-Up Studies; Galectin 3 - blood; Galectin-3; Gene expression; Heart; Heart attacks; Heart diseases; Heart failure; Heart Failure - blood; Heart Failure - mortality; Heart Failure - pathology; Humans; Inflammation; Male; Middle Aged; Molecular interactions; Mortality; Patient Readmission; Patients; Prognosis; Proportional Hazards Models; Regression analysis; Regression models; Risk; Risk Factors; Tumor necrosis factor-TNF; Spain
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0122360

Galectin-3 (Gal-3) and carbohydrate antigen 125 (CA125) have emerged as robust prognostic biomarkers in heart failure. Experimental data have also suggested a potential molecular interaction between CA125 and Gal-3; however, the biological and clinical relevance of this interaction is still uncertain. We sought to evaluate, in patients admitted for acute heart failure, the association between plasma Gal-3 with all-cause mortality and the risk for rehospitalizations among high and low levels of CA125. We included 264 consecutive patients admitted for acute heart failure to the Cardiology Department in a third-level center. Both biomarkers were measured on admission. Negative binomial and Cox regression models were used to evaluate the prognostic effect of the interaction between Gal-3 and CA125 (dichotomized by its median) with hospital readmission and all-cause mortality, respectively. During a median follow-up of 2 years (IQR = 1-2.8), 108 (40.9%) patients deaths and 365 rehospitalizations in 171 (69.5%) patients were registered. In a multivariable setting, the effect of Gal-3 on mortality and rehospitalization was differentially mediated by CA125 (p = 0.007 and p<0.001, respectively). Indeed, in patients with CA125 above median (>67 U/ml), values across the continuum of Gal-3 showed a positive and almost linear relationship with either the risk of death or rehospitalization. Conversely, when CA125 was below median (≤67 U/ml), Gal-3 lacked any prognostic effect on both endpoints. In patients with acute heart failure, Gal-3 was strongly associated with higher risk of long-term mortality and repeated rehospitalizations, but only in those patients exhibiting higher values of CA125 (above 67 U/ml).