Work

Galectin-3 as a prognostic biomarker in haemodialysis patients with preserved or mildly reduced ejection fraction

Year: 2025

Type: article

Abstract: ABSTRACT Background Risk prediction for heart failure (HF) and mortality in haemodialysis (HD) patients with preserved or mildly reduced left ventricular ejection fraction (LVEF) is challenging, as conventional markers often underperform. Galectin-3, a biomarker of fibrosis and inflammation, may offer prognostic value, but its utility in this population remains unclear. Methods We prospectively enrolled 244 incident HD patients with an LVEF ≥40%. The primary outcome was a composite of cardiovascular (CV) death or acute HF hospitalization. Secondary outcomes included all-cause mortality and individual primary outcome components. Predictive performance was assessed by comparing a baseline clinical model with models incorporating brain natriuretic peptide (BNP) and/or galectin-3, using the area under the curve (AUC), net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Results The mean baseline LVEF was 59.5% and the median BNP and galectin-3 levels were 357.5 pg/ml and 34.3 ng/ml, respectively. Over a median follow-up of 37 months, high galectin-3 levels (≥34.3 ng/ml) were associated with higher incidence rates of the primary outcome [14.09 versus 5.87 per 100 person-years (PY)] and all-cause mortality (14.09 versus 6.33 per 100 PY). In multivariate analysis, elevated galectin-3 independently predicted the composite outcome {hazard ratio [HR] 2.16 [95% confidence interval (CI) 1.17–4.00], P = .014], acute HF [HR 2.11 (95% CI 1.07–4.14), P = .033] and all-cause mortality [HR 1.90 (95% CI 1.04–3.55), P = .043]. Adding galectin-3 to the clinical model significantly improved discrimination (AUC 0.735 versus 0.678; ΔAUC 0.057; P = .025) and reclassification metrics (NRI 0.565; IDI 0.058; both P < .001). In contrast, BNP addition did not significantly enhance prediction. Conclusion In incident HD patients with an LVEF ≥40%, elevated galectin-3 was an independent predictor of CV death or acute HF events and provided incremental prognostic value beyond conventional clinical parameters and BNP. These findings support galectin-3 as a complementary biomarker for enhanced risk stratification in this population.

Source: Clinical Kidney Journal

DOI: 10.1093/ckj/sfaf306

Authors: Sei Hong Min, Insoo Kim, Jung Nam An, Hyung-Seok Lee, Sung Gyun Kim, Jwa-Kyung Kim

Institution: Hallym University Sacred Heart Hospital

Language: English

Topic: Heart Failure Treatment and Management

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,335