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RESEARCH PRODUCT

Differential Prognostic Value of Galectin-3 According to Carbohydrate Antigen 125 Levels in Transcatheter Aortic Valve Implantation

Christian HengstenbergWolfgang KoenigStefan HoldenriederJulio NúñezOliver HusserTobias RheudeTeresa TrenkwalderCostanza PellegriniAlbert M. KaselAdnan KastratiHeribert SchunkertN. Patrick MayrMichael JonerVicent Bodí

subject

Malemedicine.medical_specialtyTranscatheter aorticAdverse outcomesGalectin 3030204 cardiovascular system & hematologyRisk AssessmentTranscatheter Aortic Valve Replacement03 medical and health sciences0302 clinical medicineRisk FactorsCause of DeathGermanyInternal medicinemedicineClinical endpointHumansIn patientAgedRetrospective StudiesAged 80 and overbusiness.industryAortic Valve StenosisGeneral MedicinePrognosismedicine.diseaseSurvival RateGalectin-3CA-125 AntigenHeart failureAortic valve stenosisCardiologyFemalebusinessCarbohydrate antigenBiomarkersFollow-Up Studies

description

Galectin-3 (Gal-3) and carbohydrate antigen 125 (CA125) have been associated with adverse outcomes after transcatheter aortic valve implantation (TAVI). Experimental data have suggested a potential molecular interaction. Therefore, we assessed the association of Gal-3 and CA125 with prognosis after TAVI.A total of 439 patients were enrolled. The primary endpoint was a composite of all-cause mortality or readmission for worsening heart failure after TAVI.The primary endpoint occurred in 16.4%. Gal-3 was dichotomized at ≥ 8.71 ng/mL into elevated and not elevated. Gal-3 was elevated in 31.9% and was associated with a higher risk of the primary endpoint (25% vs 12.4%, HR, 2.26; P.001). After multivariable adjustment, the association of elevated Gal-3 with the primary endpoint was borderline significant (HR, 1.59; P=.068). CA125 was dichotomized at ≥ 18.4 U/mL, accordingly. CA125 was elevated in 51.9% and was also associated with a higher risk of the primary endpoint (25.4% vs 6.6%, HR, 4.20; P.001). After multivariable adjustment, elevated CA125 (HR, 2.83; P=.001) remained independently associated with the primary endpoint. A differential prognostic effect of Gal-3 was found across CA125 status (P for interaction=.048). Elevated Gal-3 was associated with a higher risk of the primary endpoint when CA125 was elevated (38.8% vs 18.2%, HR, 2.02; P=.015) but lacked significance when CA125 was not elevated (6.6% vs 6.7%, HR, 1.16; P=.981).In patients undergoing TAVI, Gal-3 predicted adverse clinical outcomes only when CA125 was elevated.

https://doi.org/10.1016/j.rec.2018.09.006