Serum Galectin-3 Predicts Mortality in Venoarterial Extracorporeal Membrane Oxygenation Patients

• Published in: Cardiology research and practice Vol. 2023; pp. 1 - 8
• Main Authors: Zhu, Jianlong, Guo, Dehui, Liu, Liying, Zhong, Jing
• Format: Journal Article
• Language: English
• Published: New York Hindawi 30.09.2023; John Wiley & Sons, Inc; Hindawi Limited; Wiley
• Subjects: Analysis; Blood pressure; Body mass index; Cardiac function; Cardiomyopathy; Cardiovascular disease; Extracorporeal membrane oxygenation; Heart attacks; Hypertension; Hypotension; Medical research; Medicine, Experimental; Mortality; Myocarditis; Natriuretic peptides; Normal distribution; Patient outcomes; Patients; Physiological aspects; Prognosis; Shock; Statistical analysis; Surgery; Taiwan; Type 2 diabetes; Ultrasonic imaging; Taiwan
• ISSN: 2090-8016; 2090-0597; 2090-0597
• DOI: 10.1155/2023/3917156

Objective. We investigated the potential use of galectin-3 (Gal-3) as a prognostic indicator for patients with cardiogenic shock and developed a predictive mortality model for venoarterial extracorporeal membrane oxygenation (VA-ECMO). Methods. We prospectively studied patients (survivors and nonsurvivors) who received VA-ECMO for cardiogenic shock from 2019 to 2021. We recorded baseline data, Gal-3, and B-type natriuretic peptide (BNP) before ECMO and 24–72 h after ECMO. We used multivariable logistic regression to analyze significant risk factors and construct a VA-ECMO death prediction model. Receiver operating characteristic (ROC) curves were plotted to assess the predictive efficacy of the model. Results. We enrolled 73 patients with cardiogenic shock who received VA-ECMO support; 38 (52.05%) died in hospital. The median age was 57 years (interquartile range (IQR): 48–67 years); the median duration of ECMO therapy was 5.8 days (IQR: 4.62–7.57 days); and the median intensive care unit stay was 19.04 days (IQR: 13.92–26.15 days). Compared with the nonsurvivors, survivors had lower acute physiology and chronic health evaluation (APACHE) II scores (p < 0.001), increased left ventricular ejection fraction (p < 0.05), lower Gal-3 levels at 24 and 72 h (both p = 0.001), lower BNP levels at 24 and 72 h (both p = 0.001), and higher platelet counts (p = 0.009). Further multivariable analysis showed that APACHE II score, BNP-T72, and Gal-3-T72 were independent risk factors for death in VA-ECMO patients. Gal-3 and BNP were positively correlated (p < 0.05) and decreased significantly during ECMO treatment. The areas under the ROC curve (AUC) for APACHE II score, Gal-3-T72, and BNP-T72 were 0.687, 0.799, and 0.723, respectively. We constructed a combined prediction model with an AUC of 0.884 (p < 0.01). Conclusion. Gal-3 may serve as a prognostic indicator for patients receiving VA-ECMO for cardiogenic shock. The combined early warning score is a simple and effective tool for predicting mortality in VA-ECMO patients.