Key result
Baseline Galectin-3 levels fail to predict AF recurrence or response to spironolactone.
Why the study?
Although galectin-3 is a recognized biomarker of fibrosis well studied in heart failure, data regarding its role in atrial fibrillation remain sparse.
Does spironolactone affect Gal-3 levels, and do Gal-3 levels predict AF recurrence in patients with restored sinus rhythm?
RCT (n=67)
Placebo-controlled
Randomized
No
Does spironolactone affect Gal-3 levels, and do Gal-3 levels predict AF recurrence in patients with restored sinus rhythm?
p-value: p=0.9
In patients with AF and restored sinus rhythm, Gal-3 levels correlate with thromboembolic risk, renal dysfunction, and gout, but do not predict AF recurrence or respond to spironolactone therapy.
Spironolactone therapy and AF recurrence risk assessment should not incorporate Gal-3 levels; challenges biomarker utility in this population.
INTRODUCTION: Cardiac fibrosis is the hallmark of atrial remodeling in atrial fibrillation. Galectin-3 (Gal-3) is a biomarker of fibrosis. It is well studied in heart failure, but the data about its role in atrial fibrillation are sparse. AIM: The aim of the study was to evaluate the levels of Gal-3 in patients with atrial fibrillation after sinus rhythm restoration, to examine the association between this biomarker and other factors for developing atrial fibrillation and to assess its prognostic role. MATERIALS AND METHODS: We included 67 patients (35 male) at the mean age of 67.36±7.25 years, with Gal-3 test after sinus rhythm restoration, a subgroup of participants in placebo-controlled randomized clinical trial of treatment with spironolactone. They were followed up for atrial fibrillation recurrence and hospitalizations. The effect of demographic parameters and other factors on Gal-3 levels were evaluated before and one year after treatment. RESULTS: Mean Gal-3 at baseline was 16.9±6.8 ng/ml. Higher levels of Gal-3 were associated with female gender (р=0.008), increasing age (р=0.005), renal dysfunction (p<0.0001) and gout (р=0.002). Higher thromboembolic risk as assessed by CHA2DS2-VASc score was significantly related to Gal-3. The levels of biomarker did not affect the number of atrial fibrillation recurrences (p=0.9) and hospitalizations. No correlation was found with treatment with spironolactone, antiarrhythmic and antihypertensive drugs. CONCLUSIONS: Higher Gal-3 in atrial fibrillation was associated with female sex, renal dysfunction, and history of gout. The levels of Gal-3 were not related to rhythm control. Treatment with spironolactone did not affect the biomarker of fibrosis Gal-3 in AF patients. Higher Gal-3 was related to high embolic risk.
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Kisheva et al. (2021) conducted an RCT in Atrial fibrillation with restored sinus rhythm (n=67). Spironolactone vs. Placebo / usual care was evaluated on Atrial fibrillation recurrences (p=0.9). Baseline Galectin-3 levels in patients with atrial fibrillation were associated with female sex, renal dysfunction, and gout, but did not predict atrial fibrillation recurrences (p=0.9) or respond to spironolactone treatment (p=0.69).
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