Association of plasma-soluble ST2 and galectin-3 with cardiovascular events and mortality following cardiac surgery Academic Article uri icon

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abstract

  • BACKGROUND: Cardiac surgery induces hemodynamic stress on the myocardium, and this process can be associated with significant post-operative morbidity and mortality. Soluble suppression of tumorigenicity 2 (sST2) and galectin-3 (gal-3) are biomarkers of myocardial remodeling and fibrosis; however, their potential association with post-operative changes is unknown. METHODS: We measured peri-operative plasma sST2 and gal-3 levels in two prospective cohorts (TRIBE-AKI and NNE) of over 1800 patients who underwent cardiac surgery. sST2 and gal-3 levels were evaluated for association with a composite primary outcome of cardiovascular event or mortality over median follow-up periods of 3.4 and 6.0 years, respectively, for the two cohorts. Meta-analysis of hazard ratio estimates from the cohorts was performed using random effects models. RESULTS: Cohorts demonstrated event rates of 70.2 and 66.8 per 1000 person-years for the primary composite outcome. After adjustment for clinical covariates, higher post-operative sST2 and gal-3 levels were significantly associated with cardiovascular event or mortality [pooled estimate HRs: sST2 1.29 (95% CI 1.16, 1.44); gal-3 1.26 (95% CI 1.09, 1.46)]. These associations were not significantly modified by pre-operative congestive heart failure or AKI. CONCLUSIONS: Higher post-operative sST2 and gal-3 values were associated with increased incidence of cardiovascular event or mortality. These two biomarkers should be further studied for potential clinical utility for patients undergoing cardiac surgery.

authors

  • Patel, Dipal M
  • Thiessen-Philbrook, Heather
  • Brown, Jeremiah R
  • McArthur, Eric
  • Moledina, Dennis G
  • Mansour, Sherry G
  • Shlipak, Michael G
  • Koyner, Jay L
  • Kavsak, Peter
  • Whitlock, Richard
  • Everett, Allen D
  • Malenka, David J
  • Garg, Amit
  • Coca, Steven G
  • Parikh, Chirag R

publication date

  • February 2020

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