Galectin-3–enhanced prognostic models for major adverse cardiovascular events in Vietnamese patients with acute coronary syndrome: A prospective cohort study
4 affiliations
- 1Department of Internal Medicine, University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
- 2Department of Intensive Care and Toxicology, Hoan My Cuu Long Hospital, Can Tho City, Vietnam
- 3Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
- 4Department of Interventional Cardiology, Cho Ray Hospital, Ho Chi Minh City, Vietnam
Abstract
Objective: We evaluated whether admission Galectin-3 (Gal-3) was associated with higher apparent discrimination and reclassification when added to the TIMI, HEART and GRACE scores for 12-month major adverse cardiovascular events (MACE) in Vietnamese patients with acute coronary syndrome (ACS).
Methods: This prospective observational cohort included 103 adults with ACS diagnosed according to the 2023 European Society of Cardiology criteria between August 2024 and April 2025. Patients were followed for 12 months, with final follow-up completed in April 2026. Serum Gal-3 was measured at admission. The primary endpoint was MACE, comprising all-cause death, nonfatal myocardial infarction, nonfatal stroke, unplanned hospitalization for heart failure or unplanned coronary revascularization. Discrimination of the TIMI, HEART and GRACE scores, with and without Gal-3, was assessed by area under the receiver operating characteristic curve (AUC). Reclassification was evaluated using continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI), with 95% confidence intervals estimated from 1,000 bootstrap resamples.
Results: During follow-up, 16 patients (15.5%) experienced MACE. Admission Gal-3 was higher in patients with MACE than in those without MACE (median 28.7 vs 15.4 ng/mL) and the adjusted median difference remained significant (p=0.034). Adding Gal-3 yielded higher apparent AUCs for TIMI (0.584 vs 0.804), HEART (0.580 vs 0.802) and GRACE (0.620 vs 0.797), with optimism-corrected AUCs of 0.785, 0.789 and 0.783, respectively. Given the limited number of outcome events, these estimates remain exploratory and potentially optimistic.
Conclusions: Higher admission Gal-3 levels were associated with 12-month MACE. Adding Gal-3 to established risk scores yielded higher apparent discrimination and secondary exploratory reclassification metrics; however, the magnitude of these differences remains uncertain and may still be optimistic despite bootstrap correction. These analyses should be regarded as hypothesis-generating rather than as the development of candidate clinical prediction models, and external validation in larger multicenter cohorts is required.
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BibTeX
@article{nguyen2026galectin3enhanced,
title = {{Galectin-3–enhanced prognostic models for major adverse cardiovascular events in Vietnamese patients with acute coronary syndrome: A prospective cohort study}},
author = {Bao The Nguyen and Pham Van Do and Hoa Thai Nguyen and Nhung Hong Thi Thai and Trung Ich Ly and An Viet Tran},
journal = {Science Progress},
year = {2026},
month = sep,
doi = {10.1177/00368504261490436},
url = {https://doi.org/10.1177/00368504261490436},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Galectin-3–enhanced prognostic models for major adverse cardiovascular events in Vietnamese patients with acute coronary syndrome: A prospective cohort study
AU - Bao The Nguyen
AU - Pham Van Do
AU - Hoa Thai Nguyen
AU - Nhung Hong Thi Thai
AU - Trung Ich Ly
AU - An Viet Tran
PY - 2026
DA - 2026/09/18
JO - Science Progress
DO - 10.1177/00368504261490436
UR - https://doi.org/10.1177/00368504261490436
AB - Objective: We evaluated whether admission Galectin-3 (Gal-3) was associated with higher apparent discrimination and reclassification when added to the TIMI, HEART and GRACE scores for 12-month major adverse cardiovascular events (MACE) in Vietnamese patients with acute coronary syndrome (ACS). Methods: This prospective observational cohort included 103 adults with ACS diagnosed according to the 2023 European Society of Cardiology criteria between August 2024 and April 2025. Patients were followed for 12 months, with final follow-up completed in April 2026. Serum Gal-3 was measured at admission. The primary endpoint was MACE, comprising all-cause death, nonfatal myocardial infarction, nonfatal stroke, unplanned hospitalization for heart failure or unplanned coronary revascularization. Discrimination of the TIMI, HEART and GRACE scores, with and without Gal-3, was assessed by area under the receiver operating characteristic curve (AUC). Reclassification was evaluated using continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI), with 95% confidence intervals estimated from 1,000 bootstrap resamples. Results: During follow-up, 16 patients (15.5%) experienced MACE. Admission Gal-3 was higher in patients with MACE than in those without MACE (median 28.7 vs 15.4 ng/mL) and the adjusted median difference remained significant (p=0.034). Adding Gal-3 yielded higher apparent AUCs for TIMI (0.584 vs 0.804), HEART (0.580 vs 0.802) and GRACE (0.620 vs 0.797), with optimism-corrected AUCs of 0.785, 0.789 and 0.783, respectively. Given the limited number of outcome events, these estimates remain exploratory and potentially optimistic. Conclusions: Higher admission Gal-3 levels were associated with 12-month MACE. Adding Gal-3 to established risk scores yielded higher apparent discrimination and secondary exploratory reclassification metrics; however, the magnitude of these differences remains uncertain and may still be optimistic despite bootstrap correction. These analyses should be regarded as hypothesis-generating rather than as the development of candidate clinical prediction models, and external validation in larger multicenter cohorts is required.
SN - 0036-8504
SN - 2047-7163
ER -