Kones explains that there is some indication from the CORONA study that low levels of gal-3 may suggest a better response to potent statin drugs. Recent evidence also suggests plasma gal-3 levels are inversely related to risk for incident HF and mortality in community-dwelling healthy individuals, and also inversely with renal function in established HF patients. Gal-3 is therefore not only a biomarker, but growing evidence supports the belief that it is a cause of disease as well. However, current data cannot support its use as a screening tool for HF.
Still, according to Kramer, "Heart failure biomarkers are of increasing importance for both physicians and pre-clinical researchers as quantification of biomarkers is a valuable tool in therapy monitoring, contributes to the prediction of clinical outcome, and can play a key role in patient stratification."
HF is a progressive, difficult disease to manage, characterized by early mortality, repeated hospitalizations, debilitating and constricted lifestyles, a predisposition to cachexia (wasting) and sudden death, unwanted adverse events to both drugs and devices, shortfalls in compliance with guidelines, and poor patient adherence. Prognosis remains uncertain, with almost one-third of patients having a significantly poorer prognosis than is believed by their physicians.
Although survival has improved, about half of patients with this diagnosis still perish within 4 years. For the clinician, a biomarker or other means of assisting in diagnosis to guide in the choice of therapies, help monitor patients to avoid acute recurrence, and stratify patients for discharge planning and long-term management would be most welcome. For patients and their families, such information may assist in communication and shared decision-making, help reduce uncertainty, and minimize suffering and disability. Overall, HF is an increasingly large burden to society.
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