Meta-Analysis of the Usefulness of Plasma Galectin-3 to Predict the Risk of Mortality in Patients With Heart Failure and in the General Population

Galectin-3 is an emerging biomarker of myocardial fibrosis, inflammation, and immune response. We sought to examine the relation of plasma galectin-3 with cardiovascular (CVD) mortality, all-cause mortality, and incident heart failure (HF). We performed a literature search for all relevant publications using Ovid MEDLINE, Google Scholar, and other databases up to January 2016. Two reviewers independently extracted data and assessed risk of bias. We extracted hazard ratios (HRs) from regression models that adjusted for age, gender, race, body mass index, smoking, hypertension, hyperlipidemia, diabetes, natriuretic peptides, and renal function, when available. A total of 18 studies with 32,350 participants (323,090 person-years of follow-up) met criteria for analysis. The mean age was 57.3 years and 47.2% of participants were women, with a follow-up duration median of 5 years, interquartile range: 2.9 to 10 years. Of the 18 studies, 13 (72%) adjusted for N-terminal probrain natriuretic peptide and renal function in the multivariable adjusted models. Using a random-effects meta-analysis, we found an HR of 1.10 (95% CI 1.05 to 1.14) for all-cause mortality, 1.22 (95% CI 1.05 to 1.39) for CVD mortality, and 1.12 (95% CI 1.04 to 1.21) for HF risk for each 1 SD increase in galectin-3 level. In a subgroup analysis of CVD mortality, the HR was 1.44 (1.09 to 1.79) for patients with HF and 1.09 (0.91 to 1.27) for the general population. In conclusion, our results suggest that elevated plasma galectin-3 is associated with a higher risk of all-cause mortality, CVD mortality, and HF. It may add prognostic value beyond that provided by traditional CVD risk factors.