CA125 as a Marker of Heart Failure in the Older Women: A Population-Based Analysis

Abstract

(1) Background: Cancer antigen 125 (CA125) is a glycoprotein that is expressed by tissue derived from coelomic epithelium in the pleura, peritoneum, pericardium. It has been shown that CA125 concentrations are correlated with NT-proBNP in older people with congestive heart failure (HF). We conducted a study on the association between concentrations of CA125 and NT-proBNP in a population-based cohort of older Polish women. (2) Methods: The current research is sub-study of a large, cross-sectional research project (PolSenior). The study group consisted of 1565 Caucasian women aged 65–102 years. To assess the relationship between CA125 and other variables a stepwise backward multivariate normal and skew-t regression analyses were performed. (3) Results: The median of CA125 concentration was 13.0 U/mL and values over the upper normal range limit (35 U/mL) were observed in 5.1% (n = 79) of the study cohort. The concentration of CA125 was positively related to age, hospitalization for HF and history of atrial fibrillation and chronic obstructive pulmonary disease, levels of NT-proBNP, IL-6, hs-CRP and triglycerides. We found in the multivariate analyses, that increased CA125 levels were independently associated with log10 (IL-6) (β = 11.022), history of hospitalization for HF (β = 4.619), log10 (NT-proBNP) (β = 4.416) and age (β = 3.93 for 10 years). (4) Conclusions: Despite the association between CA125 and NT-proBNP, the usefulness of CA125 for the detection of HF in older women is limited by factors such as inflammatory status and age.

Tumour biomarkers: association with heart failure outcomes

“…All biomarkers (except AFP) had linear relations with each increase in NT-proBNP quintile. A significant correlation was found between NT-proBNP and CA125, also after correction with the multivariable models, in line with previous reports that CA125 relates to congestion, and congestion is strongly linked to pulmonary and peripheral oedema, which in turn is the strongest determinant of worse functional class in HF [8]. Strikingly, CA15-3 did not increase with NT-proBNP, and its levels appeared to independently from behave NT-proBNP levels.…”

“…Increased levels of CA125 have been reported in patients with atrial fibrillation, HF and acute myocardial infarction, which might be induced by mechanical stress and inflammation [31,[33][34][35]. CA125 levels have been associated with the risk of adverse outcomes of HF and have been put forward as a promising biomarker for guiding HF therapy [8,36]. Interestingly, another biomarker advocated for epithelial ovarian cancer (EOC) is HE4, which is currently used to monitor recurrence and plays a role in molecular pathways related to tumour proliferation and metastasis [37,38].…”

“…For instance, surveillance programmes of colorectal cancer often make use of the tumour biomarker CEA, and for monitoring breast cancer, the tumour biomarker CA15-3 is in use. Strikingly, several presumed tumour biomarkers, such as CA125 and human epididymis protein 4 (HE4), have been shown to strongly predict outcome in HF as well [7][8][9][10]. Given the emerging appreciation that HF and cancer may be two diseases within one spectrum, these observations may actually fit this concept, and tumour biomarkers may broadly signify progression of pathways that classically were linked to certain cancers, but may also be of importance for HF progression.…”

Next Generation Plasma Proteomics Identifies High-Precision Biomarker Candidates for Ovarian Cancer

“…MUCIN-16, however, has a low sensitivity for early-stage cancer and a high rate of false positive indications in many benign gynaecological conditions in younger women, such as infections, pregnancies, and endometriosis [ 8 ]. MUCIN-16 has also been reported to be elevated above the clinically indicative cut-off for ovarian cancer (35 U/mL) in 5.1% of heart failures among elderly women [ 9 ] and in 45.7% of women with acute pancreatitis [ 10 ]. Additional biomarkers such as the WAP four-disulfide core domain 2 (WFDC2 or HE4) has been shown to increase the specificity in detection of ovarian cancer, especially in fertile women [ 11 ].…”

Novel Biomarkers of Renal Dysfunction and Congestion in Heart Failure

“…A growing body of evidence has implicated CA-125 in the pathophysiological processes underlying HF [ 120 ]. In the latter context, the glycoprotein is released in response to extravascular congestion and cytokine-induced inflammation as well as myocardial stress and injury [ 121 ]. Taking all this into consideration, CA-125, as a surrogate for fluid overload and inflammation in HF patients, emerges as a potential novel biomarker of this pathology [ 118 , 119 ].…”