Galectin-3 Could Help Predict Cardiovascular Events in Diabetics

September 9, 2020

A study from ESC Congress 2020 dove deeper into associations between specific biomarkers and risk of CV events in CAD patients with and without diabetes.

This article originally appeared on Practical Cardiology’s sister site, EndocrinologyNetwork.com.

Results of a subgroup analysis of the REWIND trial suggest galectin-3 could help clinicians better predict a diabetic patient’s risk experiencing a cardiovascular event.

Results of the study, which included more than 900 patients with coronary artery disease (CAD), found galactic-3 plasma levels were associated with increased risk of cardiovascular events in patients with CAD and type 2 diabetes while monocyte chemoattractant protein-1 (MCP-1) and N-terminal fragment of brain natriuretic peptide (NT-proBNP) were predictive of events in patients with CAD but not type 2 diabetes.

“In CAD patients, cardiovascular events are predicted by galectin-3 plasma levels in patients with type 2 diabetes mellitus, and by MCP-1 and NT-proBNP in those without type 2 diabetes mellitus,” wrote study investigators.

Despite posing a serious threat to the health of diabetic populations as a whole, particularly those suffering from coronary atherosclerosis, clinicians and researchers have been unable to identify many reliable biomarkers for predicting cardiovascular events in type 2 diabetics. In an effort to close this knowledge gap, in estimators designed a study assessing the predictive value of multiple biomarkers for predicting the risk of events including acute ischemia, heart failure, or death. Of note, investigators chose a primary outcome as a combination of the secondary outcomes, which was the occurrence of the aforementioned adverse events.

For the study, investigators identified a cohort of 964 patients with coronary artery disease and information related to plasma levels of galectin-3, MCP-1, and NT-proBNP. The median duration of follow-up for this population was 5.39 (2.81-6.92). Of the 964 included in the study, 232 patients had a confirmed diagnosis of type 2 diabetes mellitus. Overall, 75% of the patients in the type 2 diabetes group and 76.6% of patients in the non-diabetic group were men (P=.609).

Investigators noted patients with diabetes had higher mean levels of MCP-1 (144 [133-195] vs 133 [105-173] pg/ml; P=.006) and galectin-3 (8.3 [6.5-10.5] vs 7.8 [5.9-9.8] ng/ml; P=.049) than their counterparts without type 2 diabetes mellitus.

Upon analysis, investigators found galectin-3 levels were associated with an increased risk of the study’s primary outcome in patients with type 2 diabetes (HR, 1.57; 95% CI, 1.07-2.30; P=.022), along with a history of cerebrovascular events. Investigators also found treatment with clopidogrel was associated with a lower risk of the primary outcome.

Results of the analysis also revealed NT-proBNP levels but not galactic-3 were associated with an increased risk of event in patients without diabetes (HR, 1.21; 95% CI, 1.04-1.42; P=.017), along with male sex and age. Additionally, galectin-3 was the only biomarker in the study investigators found was associated with development of acute ischemic events and heart failure or death in type 2 diabetics. However, MCP-1 (HR, 1.21; 95% CI, 1.04-1.42; P=.017) and NT-proBNP (HR, 1.23; 95% CI, 1.05-1.44; P=.012) were found to be associated with these outcomes in patients without diabetes.

“Galectin-3 was also the only biomarker that predicted the development of acute ischemic events and heart failure or death in T2DM patients, while in non-diabetics MCP-1 and NT-proBNP, respectively, predicted these events,” wrote study investigators.

This study, “Galectin-3 predicts cardiovascular events in patients with type-2 diabetes," was presented at ESC Congress 2020 by Ana Lorenzo-Almoros.