Abstract 14000: Elevated Galectin-3 Levels Are Associated With Higher Mortality in Patients With Atrial Fibrillation

Introduction: Atrial fibrillation (Afib) is associated with structural and electrical atrial remodeling. Galectin-3 (Gal-3) is a mediator of atrial fibrosis and higher levels have been associated with new onset Afib. Whether Gal-3 levels are prognostic in Afib remains unknown.

Research Question: Investigate whether higher Gal-3 levels are associated with higher mortality in Afib.

Methods: Patients with a history of Afib, enrolled in the Emory Cardiovascular Biobank of patients undergoing coronary angiography for suspected or confirmed CAD were included. Primary outcomes were all-cause and cardiovascular (CV) mortality. Kaplan-Meier and Cox regression analyses were used to compare survival between different Gal-3 levels.

Results: We included 767 patients (mean age 68 years, 69.8% males) who were followed for a mean of 4.4 years. There were 234 (30%) all cause and 149 (19%) CV deaths. Third and fourth quartiles of Gal-3, were associated with higher hazard, when compared to the first quartile, with hazard ratios (HR) of 2.1 (1.4, 3.3) (Q3) and 3.5 (2.3, 5.3) (Q4) for all-cause mortality and 2.8 (1.5, 5.2) (Q3) and 4.9 (2.7, 8.7) (Q4) for cardiovascular mortality respectively. A one unit increase in Gal-3 was associated with HR of 1.4% and 1.8% for all-cause and CV mortality respectively, after adjusting for age, NT-proBNP, hypertension, stroke, MI, PVD, absence of coronary artery disease on left heart catheterization, history of HF and anti-coagulation therapy.

Conclusions: Higher levels of Gal-3 are associated with higher incidence of all-cause and cardiovascular mortality in patients with Afib. Gal-3 can be used to identify high risk patients with Afib.