16-05: Galectin 3 as a risk factor recurrence of atrial fibrillation in patients with metabolic syndrome

Purpose: Galectin 3 (Gal 3) – biomarker of fibrosis is increased in serum patients with atrial fibrillation (AF) and metabolic syndrome (MetS). We propose that Gal 3 can impact on progression of the arrhythmia. Objective of the study is to evaluate the role of Gal 3 in predicting the effect of antiarrhythmic drug therapy in patients with AF and MetS. Method: 180 patients with MetS (IDF, 2005) and paroxysmal (n = 100) or persistent (n = 80) AF were examined. Groups did not differ significantly by gender, age, eGFR (p > 0,05), volumes left and right atrium. The examination includes: medical history, anthropometry, echocardiography, serum Gal 3 (ELISA). Patients were taking antiarrhythmic drugs: amiodarone (32%), beta-blockers (42%), sotalol (12%), propafenone (14%) during 16,7 ± 6,9 months. After that we analyzed the clinical data and the effectiveness of antiarrhythmic drug therapy, which is considered effective if there were no reported paroxysms of AF during follow-up. Results: Serum Gal 3 in patients with persistent AF was higher compared to patients with paroxysmal AF (1,02 [0,52;3,14] and 0,54 [0,41;1,31] ng/ml, р = 0,03). In patients with 1-2 paroxysms in month serum Gal 3 was higher than in patients with 1-2 paroxysms in year (1,31 [0,92;4,21] and 0,53 [0,41;0,72] ng/ml, р < 0,001). Serum Gal 3 in patients with recurrent paroxysms of AF and without the effect of antiarrhythmic therapy was higher than in patients without recurrent paroxysms of AF irrespective of antiarrhythmic drug (1,31 [0,75,2,49] and 0,50 [0,41;0,72] ng / ml, p < 0.001). The multivariate regression analysis demonstrated that Gal 3 is an independent predictor of non-effective antiarrhythmic drug therapy of AF (OR = 2,38, 95% CI 1,12-5,04, p = 0.024). In patients with AF and MetS who had serum Gal 3 above 0,77 ng/ml (cut-off point on ROC-curve) the risk of non-effective antiarrhythmic therapy was in 3,6 fold higher during follow-up the study (RR = 3,6, 95% CI 1,6-7,9, p = 0,002). Conclusions: The level of serum galectin 3 in patients with persistent atrial fibrillation is higher than in patients with paroxysmal. Patients with higher level of galectin 3 have a higher risk of non-effective antiarrhythmic drug therapy, that may be an additional indication for surgical treatment.