Galectin‐3 levels and long‐term all‐cause mortality and hospitalization in heart failure patients: a meta‐analysis

Abstract

Abstract Aims This meta‐analysis investigated the dose–response relationship between circulating galectin‐3 levels and adverse outcomes in patients with heart failure (HF). Methods and results PubMed and Embase were screened for studies on galectin‐3 and HF. The outcomes of interest were all‐cause mortality (ACM), and all‐cause mortality or HF‐related rehospitalization (ACM/HFR), with a follow‐up time of more than 6 months. For categorical variables, comparisons between groups with the highest and lowest galectin‐3 levels were pooled. For continuous variables, the risks of ACM and ACM/HFR increase per 1‐standard deviation (SD) and 1‐unit after logarithmic transformation galectin‐3 levels were pooled. A random‐effects model was employed to calculate the pooled results, and all pooled results were expressed as hazard ratios (HRs) and 95% confidence intervals (CIs). Besides, a dose–response analysis was performed. Twenty‐four cohort studies were included. In HF patients, higher circulating galectin‐3 levels were significantly associated with a higher risk of long‐term ACM (HR, 1.65; 95% CI 1.28–2.13; I2 = 66%), and 1 ng/mL increase in galectin‐3 was associated with a 4% (HR, 1.04; 95% CI 1.02–1.06; P = 0.002) increase in hazard. Similarly, higher circulating galectin‐3 levels were significantly associated with a higher risk of long‐term ACM/HFR (HR, 1.52; 95% CI, 1.15 to 2.00; I2 = 76%), and 1 ng/mL increase in galectin‐3 was associated with a 3% (HR, 1.03; 95% CI 1.02–1.04; P < 0.001) increase in hazard. An increase of 1‐SD in galectin‐3 units was associated with a 29% increased hazard of long‐term ACM (HR 1.29; 95% CI 1.13–1.48; I2 = 42%) and a 22% increased hazard of ACM/HFR (HR 1.22; 95% CI 1.07–1.38; I2 = 60%). Similarly, an increase of 1‐log in galectin‐3 units was associated with a 98% higher hazard of long‐term ACM (HR 1.98; 95% CI 1.48–2.65; I2 = 41%) and an 83% higher hazard of ACM/HFR in HF patients (HR 1.83; 95% CI 1.02–3.28; I2 = 7%). Correlation analysis showed a moderate positive correlation between baseline galectin‐3 and N terminal pro brain natriuretic peptide levels (r = 0.48, P = 0.045) and a weak negative correlation with eGFR (r = −0.39, P = 0.077). Conclusions Higher circulating galectin‐3 levels after hospitalization of HF patients are linearly and positively associated with the risk of long‐term ACM and ACM/HFR.

Keywords

• Galectin‐3
• All‐cause mortality
• Heart failure
• Hospitalization
• Meta‐analysis