Dataset Information

Galectin-3 and Risk of Heart Failure and Death in Blacks and Whites.

ABSTRACT:

Background

The association between galectin-3 and heart failure (HF) or death is well established for white, but not for black, adults.

Methods and results

Galectin-3 was measured in 1809 participants (1375 white, 434 black), enrolled in a substudy of the Atherosclerosis Risk in Communities (ARIC) observational cohort during 2004-2005. We used Cox proportional hazard models to estimate the adjusted association between galectin-3 and outcomes. Analyses were conducted overall and by race category. Median (interquartile range) galectin-3 levels were 13.4 (11.2-16.4) and 14.8 (12-17.6) ng/mL, in white and black participants, respectively. In the sample overall, galectin-3 was not independently associated with HF or death over a maximum of 7.9 years. However, in race-stratified analyses, galectin-3 was independently associated with a composite of HF or death among whites (eg, hazard ratio 2.2, 95% CI 1.2-3.9, comparing Q4 versus Q1); but not among blacks (hazard ratio of 0.8 [0.4-1.8] for Q4 versus Q1, race interaction P=0.03). Associations between galectin-3 and both outcomes analyzed individually also demonstrated similar racial differences. Furthermore, results were qualitatively similar with galectin-3 modeled as a continuous exposure. In addition, galectin-3 improved discrimination for the composite of HF or death among whites (increase in Harrell's C statistic from 0.729 to 0.735 [difference of +0.006], P=0.049), but not among blacks (0.696 to 0.695 [difference of -0.001], P=0.814).

Conclusions

In contrast to whites, galectin-3 may have limited prognostic utility for predicting HF and death in blacks. While our results require replication, they could reflect racial differences in the processes by which galectin-3 mediates disease.

SUBMITTER: McEvoy JW

PROVIDER: S-EPMC4889181 | biostudies-literature | 2016 May

REPOSITORIES: biostudies-literature

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Publications

Galectin-3 and Risk of Heart Failure and Death in Blacks and Whites.

McEvoy John W JW Chen Yuan Y Halushka Marc K MK Christenson Eric E Ballantyne Christie M CM Blumenthal Roger S RS Christenson Robert H RH Selvin Elizabeth E

Journal of the American Heart Association 20160513 5

<h4>Background</h4>The association between galectin-3 and heart failure (HF) or death is well established for white, but not for black, adults.<h4>Methods and results</h4>Galectin-3 was measured in 1809 participants (1375 white, 434 black), enrolled in a substudy of the Atherosclerosis Risk in Communities (ARIC) observational cohort during 2004-2005. We used Cox proportional hazard models to estimate the adjusted association between galectin-3 and outcomes. Analyses were conducted overall and by ...[more]

PMID: 27178204

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Project description:BACKGROUND:Recent data suggest that neighborhood socioeconomic environment predicts heart failure (HF) hospital readmissions. We investigated whether neighborhood deprivation predicts risk of incident HF beyond individual socioeconomic status in a low-income population. METHODS AND RESULTS:Participants were 27 078 whites and blacks recruited during 2002 to 2009 in the SCCS (Southern Community Cohort Study), who had no history of HF and were using Centers for Medicare or Medicaid Services. Incident HF diagnoses through December 31, 2010, were ascertained using International Classification of Diseases, Ninth Revision, codes 428.x via linkage with Centers for Medicare or Medicaid Services research files. Participant residential information was geocoded and census tract determined by a spatial join to the US Census Bureau TIGER/Line Shapefiles. The neighborhood deprivation index was constructed using principal components analysis based on census tract-level socioeconomic variables. Cox models with Huber-White cluster sandwich estimator of variance were used to investigate the association between neighborhood deprivation index and HF risk. The study sample was predominantly middle aged (mean, 55.5 years), black (69%), female (63%), low income (70% earned <$15 000/y), and >50% of participants lived in the most deprived neighborhoods (third neighborhood deprivation index tertile). Over median follow-up of 5.2 years, 4300 participants were diagnosed with HF. After adjustment for demographic, lifestyle, and clinical factors, a 1 interquartile increase in neighborhood deprivation index was associated with a 12% increase in risk of HF (hazard ratio, 1.12; 95% confidence interval, 1.07-1.18), and 4.8% of the variance in HF risk (intraclass correlation coefficient, 4.8; 95% confidence interval, 3.6-6.4) was explained by neighborhood deprivation. CONCLUSIONS:In this low-income population, scant neighborhood resources compound the risk of HF above and beyond individual socioeconomic status and traditional cardiovascular risk factors. Improvements in community resources may be a significant axis for curbing the burden of HF.

Project description:Prior studies of risk factors associated with external causes of death have been limited in the number of covariates investigated and external causes examined. Herein, associations between numerous demographic, lifestyle, and health-related factors and the major causes of external mortality, such as suicide, homicide, and accident, were assessed prospectively among 73,422 black and white participants in the Southern Community Cohort Study (SCCS). Hazard ratios (HR) and 95% confidence intervals (CI) were calculated in multivariate regression analyses using the Cox proportional hazards model. Men compared with women (HR = 2.32; 95% CI: 1.87-2.89), current smokers (HR = 1.74; 95% CI: 1.40-2.17), and unemployed/never employed participants at the time of enrollment (HR = 1.67; 95% CI 1.38-2.02) had increased risk of dying from all external causes, with similarly elevated HRs for suicide, homicide, and accidental death among both blacks and whites. Blacks compared with whites had lower risk of accidental death (HR = 0.46; 95% CI: 0.38-0.57) and suicide (HR = 0.55; 95% CI: 0.31-0.99). Blacks and whites in the SCCS had comparable risks of homicide death (HR = 1.05; 95% CI: 0.63-1.76); however, whites in the SCCS had unusually high homicide rates compared with all whites who were resident in the 12 SCCS states, while black SCCS participants had homicide rates similar to those of all blacks residing in the SCCS states. Depression was the strongest risk factor for suicide, while being married was protective against death from homicide in both races. Being overweight/obese at enrollment was associated with reduced risks in all external causes of death, and the number of comorbid conditions was a risk factor for iatrogenic deaths. Most risk factors identified in earlier studies of external causes of death were confirmed in the SCCS cohort, in spite of the low SES of SCCS participants. Results from other epidemiologic cohorts are needed to confirm the novel findings identified in this study.

Dataset Information

Galectin-3 and Risk of Heart Failure and Death in Blacks and Whites.

Background

Methods and results

Conclusions

Publications

Galectin-3 and Risk of Heart Failure and Death in Blacks and Whites.

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