Gullestad L et al. – Patients with systolic HF of ischaemic aetiology who have galectin–3 values <19.0 ng/mL may benefit from rosuvastatin treatment. However, the data from this post hoc analysis should be interpreted with caution since the overall results of the CORONA study did not show a significant effect on the primary endpoint.Methods
- Patients with ischaemic systolic HF enrolled in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA) were randomly assigned to 10 mg/day of rosuvastatin or placebo.
- Galectin–3 was measured in plasma.
- The primary outcome was cardiovascular death, myocardial infarction, or stroke.
- Of 1492 patients, 411 had a primary event during a median follow–up of 32.8 months.
- There was an interaction between baseline galectin–3 and rosuvastatin on the primary endpoint (P–value for interaction = 0.036).
- Among patients with below the median plasma concentrations of galectin–3 (≤19.0 ng/mL), those assigned to rosuvastatin had a lower primary event rate [hazard ratio (HR) 0.65; 95% confidence interval (CI), 0.46–0.92; P= 0.014], lower total mortality (HR 0.70; 95% CI, 0.50–0.98; P= 0.038), and lower event rate of all–cause mortality and HF hospitalizations (HR 0.72; 95% CI, 0.54–0.98; P= 0.017) compared with placebo, but no benefit was observed in patients with higher levels of galectin–3.
- The combination of concurrently low concentrations of galectin–3 and N–terminal pro–B–type natriuretic peptide (<102.7 pmol/L) identified patients with a large benefit with rosuvastatin (HR 0.33; 95% CI, 0.16–0.67; P= 0.002).