Galectin-3 as an independent predictor of postoperative atrial fibrillation

Objective: to evaluate the significance of preoperative plasma galectin-3 levels for predicting postoperative atrial fibrillation (AFP) in a cohort of patients who underwent elective heart surgery.

Materials and methods: this prospective observational single-center cohort study was conducted at the Research Institute – Regional Clinical Hospital No. 1 n. a. prof. S.V. Ochapovsky, Krasnodar. In the period from September 1, 2023 to February 1, 2024, all patients admitted for elective coronary artery bypass grafting and/or valve surgery (valve replacement or reconstruction) were included in this study. In the early postoperative period, POAF developed in 158 patients, who formed the main group A, and from 436 patients with sinus rhythm, a control group B was generated using a random number generator, comparable with the main group in the number of observed patients and amounted to 160 patients.

Results: the onset of POAF from the beginning of the operation is 66.2±41.7 hours (on average, on the 3rd day, minimum 1 hour, maximum 166.5 hours, i.e. on the 7th day). When comparing laboratory data in patients before the operation (blood sampling was performed 12–24 hours before cardiac surgery), a statistically significant factor associated with the development of POAF was the level of galectin-3 in the blood (2.1±1.99 ng/ml in patients from group A, 1.87±1.64 ng/ml in patients from group B, p 0.01). Moreover, the blood galectin-3 level in patients with POAF significantly increased in the early postoperative period (up to 2.75±2.1 ng/ml, p <0.001), which was confirmed by the ROC curve (the area under the AUC curve was 0.522 (AUC: 0.522, 95% CI: 0.457–0.588; P =0.033)).

Conclusions: preoperative plasma galectin-3 levels have an independent value for predicting POAF and can serve as a useful prognostic parameter in a multimodal approach to risk assessment in the era of personalized treatment.

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