Galectin-3 as a sex-specific biomarker for cancer and heart failure

Fibrosis is increasingly recognized as a common mechanism linking cancer and heart failure (HF). Galectin-3 (gal-3), a lectin associated with extracellular matrix remodeling, has been proposed as a biomarker of fibrotic processes, yet its prognostic role in sex-specific contexts remains unclear.

In this post hoc analysis of the PREVEND cohort (n=5,786; median follow-up 11.5 years), investigators evaluated the association of serial gal-3 measurements with new-onset cancer and HF. A clinically relevant rise was defined as ≥50% increase in gal-3 between baseline and 4-year follow-up.

Results. During follow-up, 399 participants developed cancer (59% men) and 192 developed HF (65% men). In men, a ≥50% increase in gal-3 was independently associated with higher risk of new-onset cancer (HR 1.89; 95% CI 1.32–2.70; p<0.001) and new-onset HF (HR 1.77; 95% CI 1.07–2.95; p=0.028). Associations were particularly strong for gastrointestinal and lung cancers. In contrast, in women, neither baseline gal-3 nor serial increases were linked to risk of cancer or HF.

Interpretation. These findings reveal a striking sex-specific pattern: while women had higher absolute gal-3 levels at baseline, only increases in men carried prognostic significance. The study underscores fibrosis as a potential shared pathway for tumorigenesis and cardiac remodeling, and positions gal-3 as a candidate biomarker — and possibly a therapeutic target — in cardio-oncology, particularly for men.

#CardioOncology #Galectin3 #Fibrosis #Biomarkers #SexDifferences

Editorial note: This content was developed with support from AI technologies to optimize writing and structure. All material was reviewed, validated, and complemented by human experts prior to publication, ensuring scientific accuracy and adherence to editorial best practices.