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

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

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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.

Original languageEnglish (US)
Pages (from-to)253-263
Number of pages11
JournalAmerican heart journal
Volume220
DOIs
StatePublished - Feb 2020

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Patel, D. M., Thiessen-Philbrook, H., Brown, J. R., McArthur, E., Moledina, D. G., Mansour, S. G., Shlipak, M. G., Koyner, J. L., Kavsak, P., Whitlock, R. P., Everett, A. D., Malenka, D. J., Garg, A. X., Coca, S. G., & Parikh, C. R. (2020). Association of plasma-soluble ST2 and galectin-3 with cardiovascular events and mortality following cardiac surgery. American heart journal, 220, 253-263. https://doi.org/10.1016/j.ahj.2019.11.014