Is Galectin 3 more Accurate than Brain Natriuretic Peptide in Diagnosing Chronic Heart Failure? A Systematic Review

Abstract

Introduction: Diagnosis of chronic heart failure is difficult in primary care. The current standard biomarker Brain natriuretic
peptide (BNP) has limitations, as it only indicates conditions that cause ventricular overload and does not reveal other important mechanisms in HF. Galectin 3 (Gal-3) is an inflammatory marker and contributes to fibrosis. Gal-3 production is also independent of the loading status. Therefore, this novel biomarker may prove to be useful in CHF diagnosis. Objective: The aim of the review was to compare the diagnostic test accuracy of Gal-3 versus BNP for the detection of chronic heart failure. Method: Databases including Embase (1974 to 2019 week 12) and Medline (1946 to March Week 2 2019), Database of Abstracts of Reviews of Effects (DARE; March 2019), the Health Technology Assessment Database (HTA; March 2019) were interrogated. Results: Eligible studies evaluated one or more natriuretic peptides and galectin 3 in the diagnosis of chronic heart failure. Two studies (n = 564 participants) met our inclusion criteria. Each study compares gal-3 and BNP. Methodological quality varied considerably among studies, with a substantial amount of biases. The AUC of gal-3 was 0.891 (95% CI 0.808–0.974) and the AUC of BNP was 0.896 (95% CI 0.809 – 0.984) (BNP) whilst the other study reported the AUC of galectin 3 (0.67) and BNP (0.65) without confidence intervals. Conclusion: Gal-3 appears to have a good diagnostic biomarker for the detection of CHF although the included studies had methodological shortcomings (selection and performance bias). However, in the future, well-conducted cross-sectional studies regarding the diagnostic accuracy of gal-3 should be undertaken to examine its usefulness in clinical practice.