Prospective Validation of a Screening Biomarker Approach Combining Amino-Terminal Pro-Brain Natriuretic Peptide With Galectin-3 Predicts Death and Cardiovascular Events in Asymptomatic Hemodialysis Patients
Restricted accessResearch articleFirst published online May, 2018
Prospective Validation of a Screening Biomarker Approach Combining Amino-Terminal Pro-Brain Natriuretic Peptide With Galectin-3 Predicts Death and Cardiovascular Events in Asymptomatic Hemodialysis Patients
Cardiovascular (CV) disease is a major cause of death in hemodialysis patients.
Biomarkers used to identify high-risk asymptomatic patients would allow early evaluation
of cardiac dysfunction and appropriate therapeutic intervention. Amino-terminal pro-brain
natriuretic peptide (NT-proBNP) and galectin-3 (Gal-3) may serve this purpose. Plasma
levels of NT-proBNP and Gal-3 were measured in 173 patients. Patients were prospectively
followed for occurrences of major CV events or death. The association of NT-proBNP and
Gal-3 with outcome was analyzed. The prognostic abilities for the combined outcome of
Gal-3 and/or NT-proBNP were evaluated. During a median follow-up of 36 months, there were
47 incident outcomes (death and CV events). In the univariable Cox analysis, age,
hypertension, albumin, phosphorus levels, and combined elevation of NT-proBNP with Gal-3
above the median (hazard ratio [HR] = 3.65, 95% confidence interval [CI] = 1.45-9.21) were
associated with outcomes. In multivariable Cox analysis, both NT-proBNP and Gal-3 values
above the median remained associated with outcomes (HR = 3.34, 95% CI = 1.30-8.56). In
clinically asymptomatic dialysis patients, combined use of NT-proBNP and Gal-3 may improve
risk stratification for death and CV events.
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