Letters to the Editor Relationship between serum galectin-3 values and demographical or biochemical variables in patients without acute coronary syndrome Giuseppe Lippi a, ⁎, Gian Luca Salvagno b , Laura Bonfanti c , Gianfranco Cervellin c a Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy b Clinical Chemistry Institute, Department of Life and Reproduction Sciences, University Hospital of Verona, Verona, Italy c Emergency Department, Academic Hospital of Parma, Parma, Italy article info Article history: Received 24 August 2013 Accepted 25 November 2013 Available online 15 December 2013 Keywords: Galectin-3 Red blood cell distribution width Cardiac dysfunction Heart failure Galectin-3 has recently been introduced into clinical practice as an innovative biomarker of heart failure. In a recent article, Mayr et al. interestingly showed that galectin-3 level is associated with myocar- dial infarct size and echocardiographic parameters of impaired diastolic function and right ventricular dysfunction [1]. Another recent systematic review concluded that the serum concentration of this protein is significantly associated with abnormalities of left ventricular structure and cardiac dysfunction, exhibiting a diagnostic specificity for predicting heart failure that may be even greater than that of natriuretic peptides [2]. Therefore, despite several studies have assessed the biology of galectin-3 in patients with acute coronary syndrome (ACS) and cardiac dysfunction, no information has been provided about the potential association of this biomarker with demographical and biochemical variables in patients without ischemic heart disease. This is an important aspect to be elucidated, in order to identify potential confounding variables in galectin-3- guided risk assessment. The study population consisted in 33 consecutive patients (mean age 66 y, range, 43–83 y; 20 males and 13 females) referred to the observation unit of the Academic Hospital of Parma (Italy) over two months, for assessment of chest pain at moderate-to-high probability, in whom a diagnosis of ACS could be ruled out at emergency department (ED) admission according to criteria defined by the third universal definition of myocardial infarction [3]. All patients under- went routine laboratory testing at ED admission, including measure- ment of serum creatine, serum glucose and serum bilirubin (AU 5800; Beckman Coulter Inc., Brea CA, USA), along with standard hemocy- tometry (XE-2100; Sysmex Inc, Mundelein IL, USA). A serum aliquot was also stored at –70 °C for further assessment of galectin-3 (VIDAS; bioMérieux SA, Marcy-l'Etoile, France). The association of galectin-3 with demographical and biochemical variables, thus including age, gender, estimated glomerular filtration rate (eGFR; Modification of Diet in Renal Disease equation), serum bilirubin, serum glucose and red blood cell distribution width (RDW) was assessed in univariate and multivariate regression analysis, using Analyse-it for Microsoft Excel (Analyse-it Software Ltd, Leeds, UK). The study was performed in accordance with the Declaration of Helsinki, under the terms of relevant local legislation. The results of this study are shown in Table 1 . In univariate analysis, the concentration of serum galectin-3 was significantly associated with age and RDW, but not with gender, eGFR, serum bilirubin and serum glucose levels. In multivariate analysis, where serum galectin-3 was entered as dependent variable and age, gender, eGFR, serum bilirubin, serum glucose and RDW as independent variables, the association between galectin-3 and age was no longer significant, whereas the significant association with RDW was confirmed (Table 1). A significant agreement (0.70; 95% Confidence Interval, 0.11–0.66; p = 0.01) was also found between diagnostic values of galectin-3 (i.e., N17.8 ng/mL) [4] and increased values of RDW (i.e., N 13.5%). The results of this preliminary study on 33 ED patients without no evidence of ACS show that the serum concentration of galectin-3 is virtually independent from gender, eGFR, serum bilirubin and glucose, and seems thereby scarcely influenced by renal function, liver disease International Journal of Cardiology 171 (2014) 270–308 ⁎ Corresponding author at: U.O. Diagnostica Ematochimica, Azienda Ospedaliero- Universitaria di Parma, Via Gramsci, 14, 43126 - Parma, Italy. Tel.: +39 0521703050; fax: +39 0521 703791. E-mail addresses: glippi@ao.pr.it, ulippi@tin.it (G. Lippi). Table 1 Association of galectin-3 with demographical and biochemical variables. Results of univariate and multivariate regression analysis. Variable Univariate analysis Multivariate analysis r p β coefficient (95% CI) p Age 0.44 0.01 0.10 (-0.05 to 0.26) 0.19 Gender -0.31 0.08 -1.97 (-4.59 to 0.66) 0.14 eGFR -0.16 0.36 -0.03 (-0.07 to 0.13) 0.52 Serum bilirubin -0.08 0.64 0.33 (-4.72 to 5.38) 0.89 Serum glucose 0.04 0.82 0.03 (-0.03 to 0.08) 0.34 RDW 0.80 b 0.001 3.62 (2.24 to 5.00) b 0.001 EGFR, estimated Glomerular Filtration Rate; RDW, Red Blood Cell Distribution Width. Contents lists available at ScienceDirect International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard