Galectin-3 predicts short- and long-term outcome in patients undergoing transcatheter aortic valve implantation (TAVI)

- Level of galectin-3 was determined before transcatheter aortic valve implantation.
- Galectin-3 correlated with EUROScore, pulmonary pressure values and NT-proBNP.
- In patients with high galectin-3 more complications occurred within 30 days.
- Survival after the procedure was better when patients had low levels of galectin-3.
- We reported more cardiovascular events when values of galectin-3 were high.

Until now, no reliable biomarker has become available for short- or long-term outcome prediction in patients undergoing transcatheter aortic valve implantation (TAVI). Our goal was to investigate whether galectin-3 is also suited for risk assessment in TAVI patients. Galectin-3, a novel marker indicative for myocardial fibrosis, has prognostic value in heart failure.We included 101 patients undergoing TAVI in this prospective, single-center, observational study. Baseline galectin-3 levels were correlated to the VARC 30-day safety and one-year efficacy endpoint as well as to total mortality and cardiovascular events at one year.At baseline, mean galectin-3 level for the entire group was 18.1 (± 11.1) ng/ml. Of the 101 patients, 36 had a galectin-3 value above the cut off value of 17.8 ng/ml. These patients had significantly higher systolic pulmonary artery and capillary wedge pressures. The hazard ratio in patients with galectin-3 > 17.8 ng/ml was 3.36 (95% confidence interval, CI: 1.47-7.69; p = 0.004) for the VARC 30-day safety endpoint, 5.12 (95% CI: 2.10-12.47; p < 0.001) for one-year cardiovascular events, and 4.48 (95% CI: 1.56-12.91; p = 0.005) for all-cause mortality. This prediction remained stable even after adjusting for possible confounders including age, sex, glomerular filtration rate, and NT-proBNP. Furthermore, the prediction was even more valuable when combining galectin-3 with NTproBNP.In summary elevated galectin-3 levels are associated with adverse outcome after TAVI. Combining galectin-3 with NT-proBNP provides additive predictive value of risk stratification.