LGALS4 and heart failure: Although this is in contrast to results from previously published epidemiological studies that report associations between high Gal-4 levels and prevalent as well as incident diabetes [1], our findings showing a direct effect of stroke on plasma Gal-4 elevation are supported by studies reporting similar relationships between plasma Gal-4 and the incidence of myocardial infarction [2], heart failure [2,11], and cardiovascular and all-cause mortality [2].