Diagnostic and prognostic accuracy of galectin-3 and soluble ST2 for acute heart failure

Clin Chim Acta. 2016 Dec 1;463:158-164. doi: 10.1016/j.cca.2016.10.034. Epub 2016 Oct 29.

Abstract

Background: We aimed to compare head-to-head the diagnostic and prognostic capabilities of galectin-3, soluble ST2 (sST2) and B-type natriuretic peptide (BNP) for heart failure (HF) in an emergency setting.

Methods: We studied 251 consecutive patients with dyspnoea as a chief compliant presenting to an emergency department. The diagnosis of HF was based on the Framingham score for HF plus echocardiographic evidence of systolic or diastolic dysfunction. All-cause mortality was assessed at one year. Plasma concentrations of galectin-3 and BNP were measured with two commercially available assays from Abbott Diagnostics, plasma concentrations of sST2 were quantified with the Presage ST2 assay. The diagnostic and prognostic accuracies of galectin-3, sST2 and BNP were assessed by receiver operating characteristic (ROC) curve analysis.

Results: Of the 251 patients, 137 had dyspnoea attributable to acute HF and 114 had dyspnoea attributable to other reasons. BNP had a higher area under the curve (AUC) for the diagnosis of HF (0.92; 95% CI, 0.87-0.95) than galectin-3 (0.57; 95% CI, 0.51-0.64) and sST2 (0.63; 95% CI, 0.56-0.69). Of the 137 patients with acute HF, 41 died and 96 survived during follow up. The AUC of BNP for the prediction of one-year all-cause mortality in HF patients (0.72; 95% CI, 0.63-0.79) was not different from the AUCs of galectin-3 (0.70; 95% CI, 0.62-0.78) and sST2 (0.75; 95% CI, 0.67-0.82).

Conclusions: In this study, galectin-3, sST2 and BNP were equally useful for the prediction of one-year all-cause mortality in patients with acute HF. However, in contrast to BNP, galectin-3 and sST2 were not useful as an aid in the diagnosis of acute HF in short of breath patients presenting to an emergency department.

Keywords: Diagnostic accuracy; Galectins; Heart failure; Natriuretic peptides; Prognosis; ST2.

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Area Under Curve
  • Biomarkers / blood
  • Electrocardiography
  • Female
  • Galectin 3 / blood*
  • Heart Failure / blood*
  • Heart Failure / diagnosis*
  • Heart Failure / mortality
  • Humans
  • Interleukin-1 Receptor-Like 1 Protein / blood*
  • Interleukin-1 Receptor-Like 1 Protein / chemistry
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Prognosis
  • Survival Analysis

Substances

  • Biomarkers
  • Galectin 3
  • IL1RL1 protein, human
  • Interleukin-1 Receptor-Like 1 Protein
  • LGALS3 protein, human
  • Natriuretic Peptide, Brain