Galectin-3 – prospective biomarker of risk stratification in patients with ST-segment elevation myocardial infarction

   Galectin-3, being one of the most recent studied biomarkers, may be used as a laboratory marker of neoplastic transformation and a biomarker of chronic heart failure.

   Purpose: To evaluate the clinical and prognostic significance of galectin-3 in patients with ST- segment elevation myocardial infarction (MI).

   Material and Methods: 87 patients with ST-segment elevation myocardial infarction admitted to the hospital were included in the study. Galectin-3 levels were measured with ELISA on days1-2 in all patients. The serial measurement was performed in 81 patients on days 10–14.

   Results: Galectin-3 level was 9.5 [3.3; 11.9] ng / ml on days 1–2, and increased to 15.6 [9.9; 37.4] ng / ml after MI on days 10–14 (p = 0.003). Higher levels of galectin-3 (p = 0.04) were found in patients with a positive history of acute cerebrovascular accidents (ACVA), compared to patients without prior ACVA (42.5 [25.4; 57.1] ng / ml vs. 15.5 [9.9; 35.9] ng / ml). Galectin-3 levels in patients who had a history of hypercholesterolaemia on days 10-14 after MI increased by 47 %
(p <0.01) compared to patients without it. Similar results were observed in patients with hereditary coronary artery disease (p = 0.02). Patients with arterial hypertension demonstrated elevated galectin-3 levels on days 10–14 after MI, compared to patients without it (20.1 [10.4; 38.9] ng / ml vs. 9.9 [9.1; 33.8] ng / ml, respectively, p = 0.04). Patients with type 2 diabetes mellitus also reported higher values of the analyzed markers on days 10-14 after MI (p = 0.01). Patients with LV dilatation and reduced left ventricular ejection fraction < 40 % reported significantly higher galectin-3 levels measured on days 10-14 (p = 0.02) compared to patients with normal LV size and preserved ejection fraction. A positive correlation has been determined between galectin-3 levels and LV EDD and LV ESD (r = 0.39 and r = 0.40, respectively, p < 0.01), and an inverse correlation - between galectin-3 and left ventricular ejection fraction (r = -0.26, p = 0.02 ). CAD patients with three-vessel disease
had higher levels of galectin-3 on days 10–14 after MI days (p = 0.02), 35.8 [13.2; 43.0] ng / ml, than patients with one-vessel disease – 11.1 [9.5, 31.5] ng / ml. The serial management of galectin-3 in groups with two and three-vessel disease reported its increase by days 10–14 (10.2 [5.1; 13.3] ng / ml vs. 18.5 [10.4; 35.9] ng / ml, p <0.01; 3.4 [2.9, 4.6] ng / ml vs. 35.8 [13.2; 43.0] ng / ml, p < 0.01, respectively). A direct correlation has been determined between the levels of this biomarker on days 10–14 and door-to-balloon time (min) (r = 0.27; p = 0.02).

   Conclusion. The results of the current study have shown the possibility to use galectin-3 level for risk stratification of MI patients. Despite the large number of experimental and clinical studies of this biomarker, some matters of concern require further investigation.

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