Association of galectin-3 and soluble ST2 with in-hospital and 1-year outcomes in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.

Galectin‑3 (Gal‑3) and soluble interleukin-1 receptor-like 1 (sST2) have known prognostic value in already diagnosed heart failure (HF). To investigate the association of Gal‑3 and sST2 with prognosis in patients with ST‑segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). The analysis was based on data collected in a prospective observational BIOSTRAT (Biomarkers for Risk Stratification After STEMI; ClinicalTrials.gov identifier, NCT03735719) study. Analysis included 117 patients with first‑time STEMI treated with pPCI. Serum for Gal‑3 and sST2 was sampled 72 to 96 hours after admission due to STEMI. The patients were followed for the primary endpoint (cardiovascular [CV] death or HF hospitalization at 1 year). Both biomarkers correlated with N‑terminal pro‑B‑type natriuretic peptide (NT‑proBNP); Gal‑3 correlated with older age. Data on the primary endpoint were available for 104 patients (89%). At 1‑year follow‑up, 9 patients (8.7%) reached the primary endpoint. In univariate Cox proportional hazards regression analysis, both Gal‑3 and sST2 as continuous variables, as well as their newly‑established cutoffs (≥9.57 ng/ml for Gal‑3 and ≥45.99 ng/ml for sST2, based on the Youden index) were predictors of the primary endpoint, and of HF hospitalizations alone. Gal‑3 also predicted CV death. After adjustment for age and NT‑proBNP, Gal‑3 and sST2 remained predictors of the primary endpoint in multivariate models. In patients with first‑time STEMI treated with pPCI, baseline Gal‑3 and sST2 predicted the composite of CV death and HF hospitalization at 1 year. Both biomarkers may play an important role in CV risk stratification after STEMI, although Gal‑3 may be considered preferable.