The prognostic utility of galectin-3 in patients undergoing cardiac surgery: a scoping review

ObjectiveTo review the utility of galectin-3 (Gal-3) as a biomarker for postoperative adverse outcomes in patients undergoing cardiac surgery.MethodThis review was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic database search was conducted in October 2023. Studies that measured pre- and/or postoperative plasma Gal-3 levels in adult patients undergoing cardiac surgery were included. Primary outcomes included postoperative morbidity and mortality.ResultsOut of 391 studies screened, eight studies met the inclusion criteria. Two of the three studies showed that preoperative plasma levels of Gal-3 were associated with acute kidney injury (AKI) after cardiac surgery. Two of the three studies reported a significant increase in preoperative Gal-3 levels in patients who developed postoperative atrial fibrillation (POAF). The addition of Gal-3 to the EuroSCORE II model was found to statistically improve the prediction of both AKI and POAF. Three of the five studies suggested that Gal-3 levels can predict postoperative mortality. Finally, one study suggested that lower preoperative Gal-3 levels was associated with a higher likelihood of achieving left ventricular reverse remodeling (LVRR) after surgery.ConclusionsGal-3 may play a promising role in predicting adverse outcomes in patients undergoing cardiac surgery. The addition of Gal-3 to clinical risk prediction scores may improve their discriminatory power in this group of patients. Future studies are warranted to justify its incorporation into routine clinical practice. Galectin-3 (Gal-3) is an inflammatory protein that has recently emerged in literature as a potential biomarker for predicting mortality and cardiovascular events in cardiac surgery patients. Our review article consolidates landmark studies on the association between Gal-3 and several post-surgery outcomes such as kidney injury, atrial fibrillation, mortality, and left ventricular remodeling in adult patients. Incorporating Gal-3 in established clinical risk models such as the Society of Thoracic Surgeons (STS) scores and EuroSCORE may improve their predictive ability in diverse patient populations.