Galectin-3 and Coronary Artery Disease: An Inflammation-Based Approach

Background/Objectives: Coronary artery disease is a chronic inflammatory disorder characterized by progressive atherosclerosis and heterogeneous clinical presentations ranging from acute coronary events to stable ischemic conditions. Galectin-3 is a β-galactoside-binding lectin involved in inflammatory responses, fibrosis, and tissue remodeling, and has been investigated as a potential biomarker in cardiovascular diseases. However, its diagnostic significance across different clinical stages of coronary artery disease remains unclear. Methods: This prospective study included 180 participants who underwent coronary angiography and were classified into three groups: control (n = 60), acute coronary syndrome (n = 60), and chronic coronary syndrome (n = 60). Serum Galectin-3 concentrations were measured using an enzyme-linked immunosorbent assay. Group comparisons were performed using non-parametric statistical tests. Correlation analysis, receiver operating characteristic curve analysis, and multivariable logistic regression were conducted to evaluate diagnostic performance and independent associations. Results: Galectin-3 concentrations were significantly higher in both acute coronary syndrome and chronic coronary syndrome groups compared with the control group (p < 0.001), whereas no significant difference was observed between the two disease groups. Receiver operating characteristic analysis demonstrated limited diagnostic performance for identifying acute coronary syndrome (area under the curve 0.617, sensitivity 96.7%, specificity 43.3%, p = 0.027) and poor diagnostic performance for chronic coronary syndrome (area under the curve 0.541, sensitivity 91.7%, specificity 30.0%, p = 0.436). In multivariable analysis, Galectin-3 was not identified as an independent predictor of either clinical condition. Age and smoking were independently associated with acute coronary syndrome, while age and male sex were independently associated with chronic coronary syndrome. Conclusions: Galectin-3 levels are elevated in patients with coronary artery disease and appear to reflect the inflammatory burden associated with atherosclerosis. However, its diagnostic discrimination between different clinical stages of coronary artery disease remains limited. Larger prospective studies are required to clarify its clinical value.