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Prognostic significance of galectin-3 level in acute coronary syndrome in the setting of real clinical practice

Malinova L. I.1, Podbolotov R. A.1, Denisova T. P.2, Dovgalevsky P. Ya.1
1 - Federal State Budgetary Institution, "Saratov Research Institute of Cardiology" at the RF Ministry of Health Care, Chernyshevskogo 141, Saratov 410028
2 - State Budgetary Educational Institution of Higher Professional Education, "V. I. Razumovsky Saratov State Medical University" at the RF Ministry of Health Care, Bolshaya Kazachjya 112, Saratov 410012

Keywords: acute coronary syndrome, CHF, galectin-3, prognosis, personalization of drug therapy

DOI: 10.18087/rhj.2015.5.2103

Background. An option for optimizing the management of patients with ACS is therapy personalization based on measurement of blood markers. Aim. To evaluate clinical and predictive significance of galectin-3 (Gal-3) in ACS patients under the conditions of real clinical practice. Materials and methods. This prospective, stratified study included patients admitted to a cardiac resuscitation unit for ACS (n=74). Observation period was 12 months. Primary endpoint was a composite endpoint (CEP) including cardiovascular death and rehospitalization. Gal-3 levels were measured in EDTA plasma using the enzyme immunoassay. Results. For the observation period, 21 (28.4 %) patients reached the primary CEP; in most cases (75 %), cardiovascular death occurred within 30 days of ACS manifestation. Plasma levels of Gal-3 exceeding 17.8 ng / ml were associated with a significant increase in the risk of reaching the CET (HR, 2.06; CI, 157; 2.79). The risk of fatal outcome was practically four times higher for patients with plasma Gal-3 level above the threshold level of 17.8 ng / ml than for other patients (HR, 3.87; CI, 3.38; 4.43). Early  treatment of ACS patients with Gal-3 levels exceeding 17.8 ng / ml with higher ACEI doses (>70 % of target dose) reduced the risk for unfavorable cardiovascular events (HR, 1.87; CI, –2.16; –1.54). Conclusion. In patients with ACS, plasma levels of Gal-3 above 17.8 ng / ml are associated with higher risk for fatal outcome and rehospitalization due to aggravation of cardiac symptoms. Early treatment with high ACEI doses results in reduced risk for unfavorable cardiovascular events in ACS patients with high levels of Gal-3.
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Malinova L. I., Podbolotov R. A., Denisova T. P., Dovgalevsky P. Ya. Prognostic significance of galectin-3 level in acute coronary syndrome in the setting of real clinical practice. Russian Heart Journal. 2015;14 (5):273–280

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