Association of galectin-3 and soluble ST2 with in-hospital and 1-year outcomes in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

INTRODUCTION Galectin-3 (Gal-3) and soluble interleukin-1 receptor-like 1 (sST2) have known prognostic value in already diagnosed heart failure (HF). OBJECTIVES To investigate the association of Gal-3 and sST2 with prognosis in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). PATIENTS AND METHODS The analysis was based on data collected in a prospective observational BIOSTRAT (Biomarkers for Risk Stratification After STEMI; ClinicalTrials.gov identifier, NCT03735719) study. Analysis included 117 patients with first-time STEMI treated with pPCI. Serum for Gal-3 and sST2 was sampled 72 to 96 hours after admission due to STEMI. The patients were followed for the primary endpoint (cardiovascular [CV] death or HF hospitalization at 1 year). RESULTS Both biomarkers correlated with N-terminal pro-B-type natriuretic peptide (NT-proBNP); Gal-3 correlated with older age. Data on the primary endpoint were available for 104 patients (89%). At 1-year follow-up, 9 patients (8.7%) reached the primary endpoint. In univariate Cox proportional hazards regression analysis, both Gal-3 and sST2 as continuous variables, as well as their newly-established cutoffs (>= 9.57 ng/ml for Gal-3 and >= 45.99 ng/ml for sST2, based on the Youden index) were predictors of the primary endpoint, and of HF hospitalizations alone. Gal-3 also predicted CV death. After adjustment for age and NT-proBNP, Gal-3 and sST2 remained predictors of the primary endpoint in multivariate models. CONCLUSIONS In patients with first-time STEMI treated with pPCI, baseline Gal-3 and sST2 predicted the composite of CV death and HF hospitalization at 1 year. Both biomarkers may play an important role in CV risk stratification after STEMI, although Gal-3 may be considered preferable.