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

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

Author information

1
Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Austria. Electronic address: thomas.mueller@bs-lab.at.
2
Department of Internal Medicine, Krankenhaus Bad Ischl, Austria.
3
Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Austria.
4
Institute for Applied System Sciences and Statistics, University of Linz, Austria.

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

PMID:
27983996
DOI:
10.1016/j.cca.2016.10.034
[Indexed for MEDLINE]
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