In 26 patients with STEMI, functional imaging, T1-mapping, and late-gadolinium-enhancement were performed on a 3-T CMR scanner at baseline (days 3 to 5) and 180 days. Biomarkers were measured at days 1, 3, and 7 after STEMI. The mean initial and follow-up left ventricular ejection fraction (LVEF) were 48.3 ± 18.1% and 52.6 ± 12.3%, respectively. Initial infarct size was 11.6 ± 16.8% of LV mass. ECV in the remote myocardium at 180 days correlated with indexed end-systolic volume (r = 0.4, p = 0.045). A significant correlation was observed between galectin-3 at day 7 and ECV at 6 months (r = 0.428, p = 0.037). A trend towards a direct correlation was found for BNP (r = 0.380, p = 0.059). Multivariate analysis revealed that BNP and galectin-3 were independent predictors of long-term changes in ECV and explained nearly 30% of the variance in this parameter (r2 = 0.34; p = 0.01). A galectin-3 cutoff value of 10.15 ng/mL was the most powerful predictor of high ECV values (≥ 28.5%) at follow-up. Galectin-3 at day 7 was an independent predictor of high ECV values at follow-up (OR = 22.51; CI 95%: 2.1–240.72; p = 0.01) with 0.76 AUC (CI: 0.574–0.964; p = 0.03).
Galectin-3 measured acutely after STEMI is an independent predictor of increased ECV at 6-month follow-up that might be useful for long-term risk stratification.