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Galectin-3 predicts response to statin therapy in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA)
Gullestad, Lars Ueland, Thor Kjekshus, John Nymo, Ståle H. Hulthe, Johannes Muntendam, Pieter Adourian, Aram Bohm, Michael van Veldhuisen, Dirk J. Komajda, Michel
Gullestad, Lars
Ueland, Thor
Kjekshus, John
Nymo, Ståle H.
Hulthe, Johannes
Muntendam, Pieter
Adourian, Aram
Bohm, Michael
van Veldhuisen, Dirk J.
Komajda, Michel
Abstract
Aims: To investigate whether plasma galectin-3, a mediator of fibrogenesis, can identify patients with chronic heart failure (HF) for whom statins are effective. Methods and results: Patients with ischaemic systolic HF enrolled in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA) were randomly assigned to 10 mg/day of rosuvastatin or placebo. Galectin-3 was measured in plasma. The primary outcome was cardiovascular death, myocardial infarction, or stroke. Of 1492 patients, 411 had a primary event during a median follow-up of 32.8 months. There was an interaction between baseline galectin-3 and rosuvastatin on the primary endpoint (P-value for interaction = 0.036). Among patients with below the median plasma concentrations of galectin-3 (≤19.0 ng/mL), those assigned to rosuvastatin had a lower primary event rate [hazard ratio (HR) 0.65; 95% confidence interval (CI), 0.46–0.92; P= 0.014], lower total mortality (HR 0.70; 95% CI, 0.50–0.98; P= 0.038), and lower event rate of all-cause mortality and HF hospitalizations (HR 0.72; 95% CI, 0.54–0.98; P= 0.017) compared with placebo, but no benefit was observed in patients with higher levels of galectin-3. The combination of concurrently low concentrations of galectin-3 and N-terminal pro-B-type natriuretic peptide ( < 102.7 pmol/L) identified patients with a large benefit with rosuvastatin (HR 0.33; 95% CI, 0.16–0.67; P= 0.002). Conclusion: Patients with systolic HF of ischaemic aetiology who have galectin-3 values < 19.0 ng/mL may benefit from rosuvastatin treatment. However, the data from this post hoc analysis should be interpreted with caution since the overall results of the CORONA study did not show a significant effect on the primary endpoint.
Keywords
heart failure, lipids, cardiovascular pharmacology, atherosclerosis, statins
Date
2012
Type
Journal article
Journal
European Heart Journal
Book
Volume
33
Issue
18
Page Range
2290-2296
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled