scholarly journals Are there benefits of low doses of ACE inhibitors, MRAs, diuretics and statins in the treatment of heart failure?

2021 ◽  
Vol 14 (2) ◽  
pp. 226-231
Author(s):  
V. А. Lysenko
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Relative Risk ◽  
Ace Inhibitors ◽  
Cardiovascular Events ◽  
Beta Blockers ◽  
Scientific Data ◽  
Rank Test ◽  
Coronary Syndrome

Treatment of chronic heart failure (CHF) is very controversial. The issue of optimal doses of beta-blockers, ACE inhibitors, aldosterone receptor antagonists, statins in patients with CHF has not been conclusively addressed. Achieving the maximum tolerated doses of drugs, though related to reduced mortality, but is accompanied by an increase in adverse drug reactions. The aim. To present and discuss our own clinical and scientific data concerning the role of beta-blockers and inhibitors of the renin-angiotensin aldosterone system, diuretics, statins in the treatment of CHF patients and optimization of dosage schemes. Material and methods. The study included 88 patients with CHF of ischemic origin, with sinus rhythm, stage II AB, NYHA FC II–IV, 58 – with reduced LV EF (HFrEF) and 30 – with preserved LV EF (HFpEF). The mean age of patients was 69.18 ± 9.97 years, men 52 % (n = 46). The median follow-up of the CHF patients was 396 days, the maximum number of follow-up days was 1302. During the observation period, 14 endpoints were registered, which accounted for 15.91 % of events: 7 deaths (8.0 %), 2 strokes (2.3 %), 2 cases of acute coronary syndrome (2.3 %), 3 progressive heart failure cases (3.4 %). Kaplan–Mayer curves were drawn to assess survival rate, and the significance of difference between groups was calculated by the criteria of Gehan–Wilcoxon, Cox–Mantel and log-rank test. Risk factors were determined, and prognostic uni- and multi-variant Cox proportional hazards regression models were used. The cut-off values of quantitative risk factors were obtained by ROC analysis. Results. The increase in the relative risk of adverse cardiovascular events in the CHF patients regardless of LV EF was associated with a daily carvedilol dose of more than 25 mg (HR = 1.05; 95 % CI 1.009–1.093; P = 0.0171); eplerenone – more than 12.5 mg (HR = 1.073; 95 % CI 1.005–1.144; P = 0.034), torasemide – more than 5 mg (HR = 1.13; 95 % CI 1.021–1.255; P = 0.019); rosuvastatin – more than 10 mg (HR = 1.107; 95 % CI 1.007–1.203; P = 0.035), and the trend in using atorvastatin at a dose of less than 10 mg (HR = 1.05; 95 % CI 0.951–1.165; P = 0.327). The use of ramipril in a daily dose of less than 2.5 mg was accompanied by a trend towards the 22 % reduced relative risk of adverse cardiovascular events (HR = 0.78; 95 % CI 0.384–1.580; P = 0.491). Conclusions. Positive treatment outcomes in the CHF patients, regardless of the phenotype, were associated with low daily doses of ramipril (<2.5 mg), eplerenone/spironolactone (<12.5 mg), torasemide (<5.0 mg), rosuvastatin (<10.0 mg), but with high doses of atorvastatin (>10.0 mg).

B-Type natriuretic peptide predicts major adverse cardiac and cerebrovascular events after catheter ablation of atrial fibrillation: insights from AF frontier ablation registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Kato ◽  
K Usuda ◽  
H Tada ◽  
T Tsuda ◽  
K Takeuchi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Natriuretic Peptide ◽  
Cardiovascular Events ◽  
Curve Analysis ◽  
Funding Source ◽  
Coronary Syndrome ◽  
Cerebrovascular Events

Abstract Background High plasma B-Type natriuretic peptide (BNP) level is associated with cardiac events or stroke in patients with atrial fibrillation (AF). However, it is still unknown whether BNP predicts worse clinical outcomes after catheter ablation ofAF. Purpose We aimed to see if plasma BNP level is associated with major adverse cardiac and cerebrovascular events (MACCE) after catheter ablation of AF. Methods We retrospectively analyzed 1,853 participants (73.1% men, mean age 63.3±10.3 years, 60.7% paroxysmal AF) who received first catheter ablation of AF with pre-ablation plasma BNP level measurement and completed follow-up more than 3 months after the procedure from AF Frontier Ablation Registry, a multicenter cohort study in Japan. We evaluated an association between plasma BNP level before catheter ablation and first MACCE in cox-regression hazard models adjusted for known risk factors. MACCE were defined as stroke/transient ischemic attack (TIA), cardiovascular events or all-cause death. Results The mean plasma BNP level was 120.2±3.7 pg/mL. During a mean follow-up period of 21.9 months, 57 patients (3.1%) suffered MACCE (ischemic stroke 8 [14.0%], hemorrhagic stroke 5 [8.8%], TIA 5 [8.8%], hospitalization for heart failure 11 [19.2%], acute coronary syndrome 9 [15.8%], hospitalization for other cardiovascular events 8 [14.0%] and all-cause death 11 [19.2%]). Plasma BNP level of patients with MACCE were significantly higher than those without MACCE (291.7±47.0 vs 114.7±3.42 pg/mL, P&lt;0.001). Multivariate analysis revealed that plasma BNP level (hazard ratio [HR] per 10 pg/mL increase 1.014; 95% confidence interval [CI] 1.005–1.023; P=0.001), baseline age (HR 1.052; 95% CI 1.022–1.084; P=0.001), heart failure (HR 2.698; 95% CI 1.512–4.815; P=0.001), old myocardial infarction (HR 3.593; 95% CI 1.675–7.708; P=0.001) and non-ischemic cardiomyopathy (HR 2.676; 95% CI 1.337 - 5.355; P=0.005) were independently associated with MACCE. At receiver-operating characteristic curve analysis, plasma BNP level before catheter ablation ≥162.7 pg/mL was the best threshold to predict MACCE (area under the curve: 0.71). Kaplan-Meier curve analysis (Figure) showed that the cumulative incidence of MACCE was significantly higher in patients with a BNP ≥162.7 pg/mL than in those with a BNP below 162.7 pg/mL (HR 4.85; 95% CI 2.86–8.21; P&lt;0.001). Conclusions Elevation of plasma BNP level was independently related to the increased risk of MACCE after catheter ablation ofAF. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Bristol-Meiers Squibb

Abstract 2942: High Mortality Rates are Associated with Withdrawal of Beta Blockers and Ace Inhibitors in Chemotherapy-Induced Heart Failure

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Ashish Shukla ◽  
S Wamique Yusuf ◽  
Iyad Daher ◽  
Daniel Lenihan ◽  
Jb Durand
Keyword(s):  
Heart Failure ◽  
Cancer Patients ◽  
Ace Inhibitors ◽  
Matched Control ◽  
Beta Blockers ◽  
Left Ventricular ◽  
T Test ◽  
Rank Test ◽  
Lv Function ◽  
Kaplan Meier

Beta blockers (BB) and ACE inhibitors (ACE) are recommended for management of left ventricular (LV)dysfunction including patients with chemotherapy-induced cardiomyopathy (CCM). There is a scarcity of data for the long term requirement of these medications in cancer patients, and the effect of their withdrawal after improvement of LV function is unknown. We report a cohort study involving patients with CCM on BB and ACE who underwent withdrawal of these medications and their outcome. Methods: In a cohort of patients with CCM stabilized on BB (commonly carvedilol) and ACE, sixteen patients were identified that had therapy withdrawn and then presented with acute heart failure. Patients resumed BB and ACE therapy and outcomes of LV function and survival were evaluated. The change in LVEF by ECHO was compared using paired t-test, with a matched control population with t-test and survivability compared and calculated using Kaplan-Meier estimates and log rank test. Results: A total of 48 patients, case (n=16) and matched control (n=32), on maximal tolerated doses of ACE+BB, mean EF of 49.62% Upon withdrawal mean EF decreased to 30.62% (p<0.0001). Nine patients died within six months of discontinuation of therapy, three of sudden cardiac death. Reinstitution of carvedilol+ACE improved LVEF to a mean of 45% (p<0.0001). Discussion: This study demonstrates acute deterioration in cardiac function and survival upon withdrawal of BB and ACE in patients with CCM, and a mortality of 56.25% for case patients and 28.12% for control patients. These data indicate that BB and ACE are pivotal in cancer patients with CCM and necessitates their indefinite use.

scholarly journals Prognostic Value of Admission Mean Corpuscular Volume for Major Adverse Cardiovascular Events following Stent Implantation in Nondiabetic and Diabetic Patients with Acute Coronary Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Lele Cheng ◽  
Lisha Zhang ◽  
Junhui Liu ◽  
Wenyuan Li ◽  
Xiaofang Bai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Stent Implantation ◽  
Cardiovascular Events ◽  
Mean Corpuscular Volume ◽  
Major Adverse Cardiovascular Events ◽  
Diabetic Patients ◽  
Corpuscular Volume ◽  
Coronary Syndrome

Background. One of the key concerns of the clinician is to identify and manage risk factors for major adverse cardiovascular events (MACEs) in nondiabetic and diabetic patients with acute coronary syndrome (ACS) undergoing stent implantation. Mean corpuscular volume (MCV) is a marker of erythrocyte size and activity and is associated with prognosis of cardiovascular disease. However, the role of admission MCV in predicting MACEs following stent implantation in diabetes mellitus (DM), non-DM, or whole patients with ACS remains largely unknown. Methods and Results. A total of 437 ACS patients undergoing stent implantation, including 294 non-DM (59.08±10.24 years) and 143 DM (63.02±9.92 years), were analyzed. Admission MCV was higher in non-DM than DM patients. During a median of 31.93 months follow-up, Kaplan-Meier curve demonstrated that higher admission MCV level was significantly associated with increased MACEs in whole and non-DM, but not in DM patients. In Cox regression analysis, the highest MCV tertile was associated with higher MACEs in whole ([HR] 1.870, 95% CI 1.113-3.144, P=0.018), especially those non-DM ([HR] 2.089, 95% CI 1.077-4.501, P=0.029) patients after adjustment of several cardiovascular risk factors. MCV did not predict MACEs in DM patients. During landmark analysis, admission MCV showed better predictive value for MACEs in the first 32 months of follow-up than in the subsequent period. Finally, the receiver operating characteristic (ROC) curve was conducted to confirmed the value of admission MCV within 32 months. Conclusion. In patients with ACS, elevated admission MCV is an important and independent predictor for MACEs following stent implantation, especially amongst those without DM even after adjusting for lifestyle and clinical risk factors. However, as the follow-up period increased, the admission MCV lost its ability to predict MACEs.

scholarly journals Contrast-induced nephropathy in patients with acute coronary syndrome with ST-segment elevation: risk factors and prognosis

The Clinician ◽  
2020 ◽  
Vol 13 (3-4) ◽  
pp. 36-42
Author(s):  
O. V. Arsenicheva ◽  
N. N. Shchapovа
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Failure ◽  
Chronic Kidney Disease ◽  
Acute Coronary Syndrome ◽  
Contrast Induced Nephropathy ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment

Objective: to study the risk factors for acute renal injury, the dynamics of renal function and prognosis in patients with acute coronary syndrome with ST-segment elevation (STEACS) with contrast-induced nephropathy (CIN) after primary percutaneous coronary intervention (PCI).Materials and methods. We studied 20 patients with STEACS, who developed СIN after PCI (follow-up group), and 98 patients with STEACS without СIN (comparison group). All patients were measured plasma creatinine level and glomerular filtration rate by the formula CKD-EPI before and 48 hours after PCI. CIN was detected with an increase in creatinine levels in the blood by more than 26.5 µmol / l from the baseline 48 hours after administration of radiopaque drug (RCP). Endpoints were evaluated at the hospital stage and within 12 months after PCI.Results. CIN after PCI occurred in 16.9 % of patients with STEACS. Among patients with СIN, persons aged over 75 years (60 %), with diabetes mellitus (45 %), chronic kidney disease (75 %), postinfarction cardiosclerosis (50 %), chronic heart failure of functional class III–IV (80 %), developed acute heart failure T. Killip III–IV (90 %) were significantly more often observed. The left ventricular ejection fraction was lower in patients with СIN (p <0.05). The average increase in plasma creatinine 48 hours after PCI was higher in the follow-up group (p <0.05). In patients with СIN more often, than without СIN, three-vascular lesions of the coronary bed were detected (65 and 25.5 % respectively, p <0.001). The same trend was observed, when assessing the average number of coronary artery stenoses, the number of implanted stents and the volume of RCP used. Patients with СIN, than without СIN, were longer in hospital (12.1 ± 0.96 and 10.2 ± 1.11 days respectively, p <0.05) and more often needed re-hospitalization within 12 months after PCI (34 and 4.1 % respectively, p <0.05).Summary. CIN in patients with STEACS after primary PCI was more likely to develop, if the following symptoms were present: age over 75 years, diabetes mellitus, chronic heart failure, post-infarction cardiosclerosis, chronic kidney disease, low ejection fraction of the left ventricle, initially high creatinine level, development of acute heart failure, trisovascular coronary lesion and multiple coronary stenting. The duration of hospital stay and the frequency of re-hospitalizations within a year after PCI significantly increased in patients in the CIN group.

scholarly journals The Influence of Cardiovascular Risk Factors and Hypogonadism on Cardiac Outcomes in an Aging Population of Beta-Thalassemia Patients

2021 ◽  
Vol 9 (1) ◽  
pp. 3
Author(s):  
Umberto Barbero ◽  
Matteo Ajassa ◽  
Carmen Maria Gaglioti ◽  
Antonio Piga ◽  
Giovanni Battista Ferrero ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Events ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Risk Equation ◽  
Modifying Factors

Beta-thalassemia major (β-TM) is a hereditary genetic disease worsened by many comorbidities due to transfusion-related iron despite chelation therapy. Since there has recently been an increase in life expectancy of patients to up to 50 years old, which influences the prevalence of these diseases and the time span for traditional cardiovascular risk factors to play their role, this study aims to evaluate their distribution and prevalence in a population of thalassemia major patients and their relationship with observed cardiovascular events and potential modifying factors. One hundred and fifty-nine β-TM patients with at least 15 years of follow-up were included in this study. The mean age was 40.9 ± 8.4 years; 28% had diabetes mellitus and 62% had hypogonadism. The cardiovascular risk assessed using algorithms (CUORE and Pooled Cohort Risk Equation—PCRE) was low, but 3.8% of patients had at least one episode of heart failure, 35.9% showed early signs of heart failure, 22% received a diagnosis of diastolic dysfunction, and 21.4% showed supraventricular arrhythmias. Hypogonadism was shown to be related to the occurrence of cardiovascular events. The chronic accumulation of iron in the heart and the specific metabolic profile, mainly observed in patients with hypogonadism, allows us to define β-TM as a condition with a high level of cardiovascular risk from many points of view (iron-related myopathy, atherosclerosis and arrhythmias), which requires better stratification tools and a specific follow-up program.

scholarly journals The Costs and Cardiovascular Benefits in Patients with Peripheral Artery Disease Receiving a Fourth-Generation Synchronous Telehealth Program (Preprint)

2020 ◽  
Author(s):  
Jenkuang Lee ◽  
Chi-Sheng Hung ◽  
Ching-Chang Huang ◽  
Ying-Hsien Chen ◽  
Hui-Wen Wu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Ischemic Stroke ◽  
Lower Risk ◽  
Cardiovascular Events ◽  
Control Group ◽  
Peripheral Artery ◽  
Coronary Syndrome ◽  
Artery Disease

BACKGROUND Patients with peripheral artery disease (PAD) are at high risk for major cardiovascular events (MACE), including myocardial infarction, stroke, and hospitalization for heart failure. We have previously shown the clinical efficacy of a 4th-generation synchronous telehealth program for some patients, but the costs and cardiovascular benefits of the program for PAD patients remain unknown. OBJECTIVE The telehealth program is now widely used by higher-risk cardiovascular patients to prevent further cardiovascular events. This study investigated whether patients with PAD would also have better cardiovascular outcomes after participating in the 4th-generation synchronous telehealth program. METHODS This was a retrospective cohort study. We screened 5062 patients with cardiovascular diseases who were treated at National Taiwan University Hospital and then enrolled 391 patients with the diagnosis of PAD. Of these patients, 162 took part in the telehealth program, while 229 did not and thus served as control patients. Inverse probability of treatment weighting (IPTW) based on the propensity score was used to mitigate possible selection bias. Follow-up outcomes included heart failure hospitalization (HFH), acute coronary syndrome (ACS), stroke, and all-cause readmission during the 1-year follow-up period and through the last follow-up. RESULTS The mean follow-up duration was 3.1 ± 1.8 years for the patients who participated in the telehealth program and 3.2 ± 1.8 years for the control group. The telehealth program patients exhibited lower risk of ischemic stroke than the control group in the first year after IPTW (0.9% vs. 3.5%; hazard ratio [HR] 0.24, 95% CI 0.07–0.80). The 1-year composite endpoint of vascular accident, including acute coronary syndrome and stroke, was also significantly lower in the telehealth program group after IPTW (2.4% vs. 5.2%; [HR] 0.46, 95% CI 0.21–0.997). At the end of the follow-up, the telehealth program group continued to exhibit a significantly lower rate of ischemic stroke than the control group after IPTW (0.9% vs. 3.5%; [HR] 0.52, 95% CI 0.28–0.93). Furthermore, the medical costs of the telehealth program patients were not higher than those of the control group, whether in terms of outpatient, emergency department, hospitalization, or total costs. CONCLUSIONS The PAD patients who participated in the 4th-generation synchronous telehealth program exhibited lower risk of ischemic stroke events over both mid- and long-term follow-up periods. However, larger scale and prospective randomized clinical trials are needed to confirm our findings.

scholarly journals Initial Therapy of Polycythemia Vera (PV) with Interferon Alfa (rIFNa) Compared to Hydroxyurea (HU) or Phlebotomy Only (PHL-O) Is Associated with a Lower Risk of Secondary Myelofibrosis

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4316-4316
Author(s):  
Ghaith Abu-Zeinah ◽  
Spencer Krichevsky ◽  
Claudia Sosner ◽  
Niamh Savage ◽  
Joseph Scandura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Relative Risk ◽  
Data Collection ◽  
Lower Risk ◽  
Cardiovascular Events ◽  
Initial Therapy ◽  
Age At Diagnosis ◽  
Risk Category

Abstract Background. Interferon alpha (rIFNa) has been used as an initial therapy for polycythemia vera (PV) at our institution since the 1980s owing to its efficacy and tolerability at the administered doses(Silver, 2006), and because of emerging evidence that it may alter its natural history(Kiladjian, Giraudier, & Cassinat, 2016). The European Leukemia Net 2018 and other groups included rIFNa in the initial management recommendations of PV. However, there is a need for studies comparing long-term outcomes of patients treated with rIFNa to those treated with standard-of-care, Hydroxyurea (HU) or Phlebotomy only (PHL-O) in the initial setting. Objectives. The primary objective of this retrospective study compared the overall survival (OS) and the myelofibrosis progression-free survival (MPFS) of patients initially treated with rIFNa to those initially treated with HU or PHL-O. The secondary objective compared the rates of cardiovascular events occurring during treatment with rIFNa and HU at any line of therapy. Methods. Data extracted from the medical records of PV patients at Weill Cornell Medicine from 1974 until 2018 included date of diagnosis, CV risk factors, CV events, therapies, myelofibrotic progression and survival. Initial therapy was defined as the earliest treatment given for at least one year. Fisher's exact test compared demographic and clinical differences among initial rIFNa, HU, and PHL-O treatment groups and Kaplan-Meier analysis compared OS and MPFS. The risk of cardiovascular events was compared using Cox Proportional Hazards regression analysis. Results. Data collection was completed for 84 of 320 PV patients. Of the 84, 16(19%), 25(30%) and 28(33%) were treated with initial rIFNa, HU and PHL-O respectively, and 15(18%) received other initial therapies. The 15 patients who received other initial therapies were excluded from the analysis. The overall median age at diagnosis was 52.9 years (range 1.5-81) which was not statistically different between the 3 subgroups (rIFNa: 49.7 [1.5-68], HU: 56.7 [29-81], and PHL-O: 51.6 [29-69]). The cohort had 35 (51%) females and the three subgroups were similar in gender distribution (Table 1). The subgroups were also similar in CV risk factors. They differed significantly in PV risk category (p=0.02) and thrombosis history (p=0.04), with the HU subgroup having more high risk patients and more patients with a history of thrombosis (Table1). The median follow-up duration of the entire cohort was 12 years (range 1-44) and the median initial treatment duration was 4.3 years (range 1-26) (Table1). The median OS of the cohort was 12 years (95% CI: 9.6,15.5) (Figure 1a). The primary outcome of median OS was not significantly different among subgroups and was 15 years for rIFNa (95% CI: 4.8, 28), 12.6 years for HU (95% CI: 10.5, 24.5), and 13 years for PHL-O (95% CI: 9.8, 24.1) (Figure 1b). The MPFS however, was significantly longer with rIFNa compared to HU or PHL, with a median that was not reached within the defined follow-up duration (Figure 2). Older age at diagnosis was associated with significantly increased risk of progression to myelofibrosis (HR 1.05, relative risk per year, p=0.02). After adjusting for age in a Cox model, the relative risk of myelofibrosis progression trended lower when comparing initial rIFNa to HU patients, but did not meet pre-established statistical cutoffs (HR 0.14, 95% CI 0.02-1.17, p=0.07). The risk of CV events, after adjusting for age, PV risk category, CV risk factors, and thrombosis history, also tended to be lower during rIFNa therapy than during HU therapy, but the difference was not statistically significant (HR 0.23, CI 0.05-1.11, p=0.07). Conclusion. No significant difference in overall survival was observed between PV patients treated with initial rIFNa compared to initial HU or PHL-O. Initial treatment with rIFNa was associated with a lower risk of myelofibrotic progression. However, this risk was not statistically significant after adjusting for age at diagnosis, which was a predictor of myelofibrosis progression in this sample cohort. Finally, the risk-adjusted incidence of cardiovascular events was lower during IFNa therapy than HU therapy. A larger cohort is needed to validate these findings and accordingly, the data collection and analysis for our total cohort of 320 patients is ongoing. Disclosures No relevant conflicts of interest to declare.

Withdrawal of beta blockers and ACE inhibitors in chemotherapy induced heart failure leads to severe adverse cardiovascular events

2003 ◽  
Vol 9 (5) ◽  
pp. S77 ◽  
Author(s):  
Daniel J. Lenihan ◽  
Ann Tong ◽  
Myrshia Woods ◽  
S.Wamique Yusuf ◽  
Anecita Fadol ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ace Inhibitors ◽  
Cardiovascular Events ◽  
Beta Blockers

scholarly journals Prognostic Utility of Galectin-3 for Recurrent Cardiovascular Events During Long-term Follow-up in Patients with Stable Coronary Heart Disease: Results of the KAROLA Study

2016 ◽  
Vol 62 (10) ◽  
pp. 1372-1379 ◽  
Author(s):  
Henning Jansen ◽  
Wolfgang Koenig ◽  
Andrea Jaensch ◽  
Ute Mons ◽  
Lutz P Breitling ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Events ◽  
Stable Coronary Heart Disease ◽  
Galectin 3 ◽  
Long Term Follow Up

Abstract BACKGROUND Galectin-3 has emerged as a potential useful novel biomarker for heart failure and cardiovascular disease (CVD). However, it remains unclear whether galectin-3 is associated with recurrent cardiovascular events during long-term follow-up of patients with stable coronary heart disease (CHD) after adjustment for multiple established and novel risk factors. METHODS We measured galectin-3 at baseline in a cohort consisting of 1035 CHD patients and followed them for 13 years to assess a combined CVD end point. Moreover, we adjusted for multiple traditional and novel risk factors. RESULTS Galectin-3 concentration was positively associated with the number of affected coronary arteries, history of heart failure, and multiple traditional risk factors. Also, galectin-3 correlated significantly with emerging risk factors [e.g., cystatin C, N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity (hs)-troponin]. During follow-up (median 12.0 years), 260 fatal and nonfatal CVD events occurred. The top quartile of galectin-3 concentration was significantly associated with CVD events compared to the bottom quartile after adjustment for age and sex [hazard ratio (HR) 1.88 (95% CI, 1.30–2.73), P = 0.001 for trend] as well as for established CVD risk factors (HR 1.67, 95% CI, 1.14–2.46, P = 0.011 for trend). However, after adjustment for other biomarkers available [including eGFR (estimated glomerular filtration rate), sST2 protein, GDF-15 (growth differentiation factor 15), NT-proBNP, and hs-troponin], the association was no longer statistically significant [HR 1.11 (95% CI 0.72–1.70), P = 0.82 for trend]. CONCLUSIONS Galectin-3 does not independently predict recurrent cardiovascular events in patients with established CHD after adjustment for markers of hemodynamic stress, myocardial injury, inflammation, and renal dysfunction.

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