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Open AccessArticle

The Predictive Value of Plasma Brain Natriuretic Peptide and Galectin-3 in Elderly Patients Admitted for Heart Failure

1
Cardiovascular Rehabilitation-Heart Failure Unit Ospedale SS Trinità Fossano, 12045 Fossano, Italy
2
Emergency 118 ASL CN1 Cuneo, 12100 Cuneo, Italy
3
School of Geriatry Università degli Studi Torino, 10134 Turin, Italy
4
Division of Cardiology, Ospedale Regina Montis Regalis, Strada del Rocchetto 99, 12084 Mondovì, Italy
*
Authors to whom correspondence should be addressed.
This study did not have any financial support.
Diseases 2018, 6(4), 88; https://doi.org/10.3390/diseases6040088
Received: 29 July 2018 / Revised: 11 September 2018 / Accepted: 21 September 2018 / Published: 27 September 2018
(This article belongs to the Section Cardiology)
Galectin-3 is demonstrated to be a robust independent marker of cardiovascular mid-term (18-month) outcomes in heart failure (HF) patients. The aim of this study was to analyze the value of a pre-discharged determination of galectin-3 alone and with brain natriuretic peptide (BNP) in predicting mid-term outcomes in elderly patients (>70 years old) discharged after an acute decompensated HF (ADHF) episode. Methods: all elderly (≥70 years old) HF subjects discharged alive after an ADHF were enrolled. All patients underwent a determination of BNP and galectin-3, a 6-min walking test (6MWT), and an echocardiogram within 48 h of hospital discharge. Cardiac death, cardiac transplantation, and worsening heart failure requiring readmission to hospital were considered cardiovascular events. Results: 84 patients (63 males (75%), age 77.5 ± 5.9 years old) were analyzed (mean follow-up: 16.2 ± 12.3 months). During the follow-up, 45 events (53.6%) were scheduled (18 cardiac deaths, 27 re-hospitalizations for ADHF). HF patients who suffered an event demonstrated more impaired ventricular function (p = 0.04), higher value of BNP (p = 0.02), and Gal-3 at a pre-discharge evaluation (p = 0.05). By choosing adequate cut-off points (BNP ≥ 500 pg/mL and Gal-3 ≥ 17.6 ng/mL), the Kaplan–Meier curves depicted a powerful stratification using Galectin-3 > 17.6 ng/mL alone (log-rank 13.22; p = 0.0003), and by adding BNP + Gal-3, an even better result was obtained (log-rank 17.96; p < 0.00001). Conclusion: in an elderly population, by adding Gal-3 to BNP, a single pre-discharge strategy testing seemed to obtain a satisfactorily predictive value in alive HF patients discharged after an ADHF episode. View Full-Text
Keywords: galectin-3; B type-natriuretic peptide; heart failure; elderly galectin-3; B type-natriuretic peptide; heart failure; elderly
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Testa, M.; Rosso, G.L.; Ferreri, C.; Feola, M. The Predictive Value of Plasma Brain Natriuretic Peptide and Galectin-3 in Elderly Patients Admitted for Heart Failure. Diseases 2018, 6, 88.

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