Galectin‐3 levels and long‐term all‐cause mortality and hospitalization in heart failure patients: a meta‐analysis.

Aims: This meta‐analysis investigated the dose–response relationship between circulating galectin‐3 levels and adverse outcomes in patients with heart failure (HF). Methods and results: PubMed and Embase were screened for studies on galectin‐3 and HF. The outcomes of interest were all‐cause mortality (ACM), and all‐cause mortality or HF‐related rehospitalization (ACM/HFR), with a follow‐up time of more than 6 months. For categorical variables, comparisons between groups with the highest and lowest galectin‐3 levels were pooled. For continuous variables, the risks of ACM and ACM/HFR increase per 1‐standard deviation (SD) and 1‐unit after logarithmic transformation galectin‐3 levels were pooled. A random‐effects model was employed to calculate the pooled results, and all pooled results were expressed as hazard ratios (HRs) and 95% confidence intervals (CIs). Besides, a dose–response analysis was performed. Twenty‐four cohort studies were included. In HF patients, higher circulating galectin‐3 levels were significantly associated with a higher risk of long‐term ACM (HR, 1.65; 95% CI 1.28–2.13; I2 = 66%), and 1 ng/mL increase in galectin‐3 was associated with a 4% (HR, 1.04; 95% CI 1.02–1.06; P = 0.002) increase in hazard. Similarly, higher circulating galectin‐3 levels were significantly associated with a higher risk of long‐term ACM/HFR (HR, 1.52; 95% CI, 1.15 to 2.00; I2 = 76%), and 1 ng/mL increase in galectin‐3 was associated with a 3% (HR, 1.03; 95% CI 1.02–1.04; P < 0.001) increase in hazard. An increase of 1‐SD in galectin‐3 units was associated with a 29% increased hazard of long‐term ACM (HR 1.29; 95% CI 1.13–1.48; I2 = 42%) and a 22% increased hazard of ACM/HFR (HR 1.22; 95% CI 1.07–1.38; I2 = 60%). Similarly, an increase of 1‐log in galectin‐3 units was associated with a 98% higher hazard of long‐term ACM (HR 1.98; 95% CI 1.48–2.65; I2 = 41%) and an 83% higher hazard of ACM/HFR in HF patients (HR 1.83; 95% CI 1.02–3.28; I2 = 7%). Correlation analysis showed a moderate positive correlation between baseline galectin‐3 and N terminal pro brain natriuretic peptide levels (r = 0.48, P = 0.045) and a weak negative correlation with eGFR (r = −0.39, P = 0.077). Conclusions: Higher circulating galectin‐3 levels after hospitalization of HF patients are linearly and positively associated with the risk of long‐term ACM and ACM/HFR. [ABSTRACT FROM AUTHOR]