Wouter C Meijers1, James L Januzzi2, Christopher deFilippi3, Aram S Adourian4, Sanjiv J Shah5, Dirk J van Veldhuisen1, Rudolf A de Boer6. 1. University of Groningen, Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands. 2. Massachusetts General Hospital, Division of Cardiology, Boston, MA. 3. University of Maryland School of Medicine, Department of Medicine, Baltimore, MD. 4. BG Medicine, Waltham, MA. 5. Northwestern University Feinberg School of Medicine, Division of Cardiology, Chicago, IL. 6. University of Groningen, Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands. Electronic address: r.a.de.boer@umcg.nl.
Abstract
BACKGROUND: Rehospitalization is a major cause for heart failure (HF)-related morbidity and is associated with considerable loss of quality of life and costs. The rate of unplanned rehospitalization in patients with HF is unacceptably high; current risk stratification to identify patients at risk for rehospitalization is inadequate. We evaluated whether measurement of galectin-3 would be helpful in identifying patients at such risk. METHODS: We analyzed pooled data from patients (n = 902) enrolled in 3 cohorts (COACH, n = 592; PRIDE, n = 181; and UMD H-23258, n = 129) originally admitted because of HF. Mean patient age was between 61.6 and 72.9 years across the cohorts, with a wide range of left ventricular ejection fraction. Galectin-3 levels were measured during index admission. We used fixed and random-effects models, as well as continuous and categorical reclassification statistics to assess the association of baseline galectin-3 levels with risk of postdischarge rehospitalization at different time points and the composite end point all-cause mortality and rehospitalization. RESULTS: Compared with patients with galectin-3 concentrations less than 17.8 ng/mL, those with results exceeding this value were significantly more likely to be rehospitalized for HF at 30, 60, 90, and 120 days after discharge, with odds ratios (ORs) of 2.80 (95% CI 1.41-5.57), 2.61 (95% CI 1.46-4.65), 3.01 (95% CI 1.79-5.05), and 2.79 (95% CI 1.75-4.45), respectively. After adjustment for age, gender, New York Heart Association class, renal function (estimated glomerular filtration rate), left ventricular ejection fraction, and B-type natriuretic peptide, galectin-3 remained an independent predictor of HF rehospitalization. The addition of galectin-3 to risk models significantly reclassified patient risk of postdischarge rehospitalization and fatal event at each time point (continuous net reclassification improvement at 30 days of +42.6% [95% CI +19.9%-65.4%], P < .001). CONCLUSIONS: Among patients hospitalized for HF, plasma galectin-3 concentration is useful for the prediction of near-term rehospitalization.
BACKGROUND: Rehospitalization is a major cause for heart failure (HF)-related morbidity and is associated with considerable loss of quality of life and costs. The rate of unplanned rehospitalization in patients with HF is unacceptably high; current risk stratification to identify patients at risk for rehospitalization is inadequate. We evaluated whether measurement of galectin-3 would be helpful in identifying patients at such risk. METHODS: We analyzed pooled data from patients (n = 902) enrolled in 3 cohorts (COACH, n = 592; PRIDE, n = 181; and UMD H-23258, n = 129) originally admitted because of HF. Mean patient age was between 61.6 and 72.9 years across the cohorts, with a wide range of left ventricular ejection fraction. Galectin-3 levels were measured during index admission. We used fixed and random-effects models, as well as continuous and categorical reclassification statistics to assess the association of baseline galectin-3 levels with risk of postdischarge rehospitalization at different time points and the composite end point all-cause mortality and rehospitalization. RESULTS: Compared with patients with galectin-3 concentrations less than 17.8 ng/mL, those with results exceeding this value were significantly more likely to be rehospitalized for HF at 30, 60, 90, and 120 days after discharge, with odds ratios (ORs) of 2.80 (95% CI 1.41-5.57), 2.61 (95% CI 1.46-4.65), 3.01 (95% CI 1.79-5.05), and 2.79 (95% CI 1.75-4.45), respectively. After adjustment for age, gender, New York Heart Association class, renal function (estimated glomerular filtration rate), left ventricular ejection fraction, and B-type natriuretic peptide, galectin-3 remained an independent predictor of HF rehospitalization. The addition of galectin-3 to risk models significantly reclassified patient risk of postdischarge rehospitalization and fatal event at each time point (continuous net reclassification improvement at 30 days of +42.6% [95% CI +19.9%-65.4%], P < .001). CONCLUSIONS: Among patients hospitalized for HF, plasma galectin-3 concentration is useful for the prediction of near-term rehospitalization.
Authors: Devin M Parker; Sherry L Owens; Niveditta Ramkumar; Donald Likosky; Anthony W DiScipio; David J Malenka; Todd A MacKenzie; Jeremiah R Brown Journal: Ann Thorac Surg Date: 2019-07-20 Impact factor: 4.330
Authors: Jennifer E Ho; Wei Gao; Daniel Levy; Rajalakshmi Santhanakrishnan; Tetsuro Araki; Ivan O Rosas; Hiroto Hatabu; Jeanne C Latourelle; Mizuki Nishino; Josée Dupuis; George R Washko; George T O'Connor; Gary M Hunninghake Journal: Am J Respir Crit Care Med Date: 2016-07-01 Impact factor: 21.405
Authors: Jeffrey P Jacobs; Shama S Alam; Sherry L Owens; Devin M Parker; Michael Rezaee; Donald S Likosky; David M Shahian; Marshall L Jacobs; Heather Thiessen-Philbrook; Moritz Wyler von Ballmoos; Kevin Lobdell; Todd MacKenzie; Allen D Everett; Chirag R Parikh; Jeremiah R Brown Journal: Ann Thorac Surg Date: 2018-06-01 Impact factor: 4.330