Carbohydrate Antigen 125 Predicts Long‐Term Mortality in African American Patients With Acute Decompensated Heart Failure

Abstract

The goal of this study was to evaluate the relation between serum levels of carbohydrate antigen 125 (CA125) and prognosis in African American (AA) patients with heart failure (HF). Little is known about the usefulness of CA125 in the AA population, which has different pathophysiology and higher prevalence of HF. The authors enrolled 172 consecutive AA patients (mean age, 55.8 years; 61.1% men) admitted with a clinical diagnosis of acute decompensated HF. CA125 was measured within 48+/-12 hours of presentation. Patients were grouped according to CA125 levels into quartiles. The median CA125 level was 16 U/mL. Serum levels of CA125 were elevated (>35 U/mL) in 58 patients (33.7%). Fifty-two patients (30.8%) died over a median follow-up period of 40 months. The CA125 threshold derived from the receiver operating characteristic curves for the prediction of mortality was 35 U/mL. In a multivariate analysis, CA125 levels >35 U/mL were found to be predictive of 40-month all-cause mortality (adjusted hazard ratio, 2.53; confidence interval, 1.40-4.59; P=.002). However, CA125 levels were not associated with 18-month HF rehospitalization. CA125 value is a strong and independent predictor of long-term mortality in AA patients admitted with a diagnosis of acute decompensated HF. Identifying a higher-risk cohort might allow for a more targeted treatment approach.

Carbohydrate Antigen 125

“…[24][25][26][27] In 2007, Nunez et al first showed that patients with acute HF exhibited a sevenfold increase in the mean CA-125 serum levels as compared with controls. [24][25][26][27] In 2007, Nunez et al first showed that patients with acute HF exhibited a sevenfold increase in the mean CA-125 serum levels as compared with controls.…”

“…24 More recently they analyzed 293 consecutive patients admitted with acute HF where CA-125 and brain natriuretic peptide (BNP) were measured at discharge and at the first ambulatory visit (median 31 days after discharge). 27 The behavior of CA-125 during acute myocardial infarction associated with acute HF was evaluated by Yalta et al 28 and it was observed that elevation in CA-125 was correlated with the severity of left ventricular systolic dysfunction. Even in African American patients with acute decompensated HF, the CA-125 values were elevated (greater than 35 U⁄mL) in 33.7% of patients.…”

“…Patients showing a clinical improvement, as evidenced by a decrease in NYHA functional class and/or positive variations in the hemodynamic profile on right heart catheterization or Doppler echocardiography, also presented a significant reduction in CA-125 levels. 2,13,20,[24][25][26][27]29 In our study, 2 a significant difference in short-term outcome was observed between patients with normal or elevated CA-125 levels obtained at the time of hospital admission: at a follow-up of 6 ± 3 months, hard events, such as death or worsening CHF re-hospitalization, were observed in 70 out of 113 subjects with CA-125 value >35 U/mL, as compared with 16 out of 127 patients with CA-125 values less than 35 U/mL. 2 The same results have been confirmed by Nägele et al 1,3 and others.…”

“…27 Therefore, in patients admitted with acute HF, CA-125 added prognostic value beyond the information provided by BNP, and thus their combination enables better 6 months risk stratification. 27 Therefore, in patients admitted with acute HF, CA-125 added prognostic value beyond the information provided by BNP, and thus their combination enables better 6 months risk stratification.…”

Developments in Heart Failure 2010

“…Tumor marker carbohydrate antigen 125 is another biomarker that is increasingly associated with hemodynamic and echocardiographic parameters and also predicts mortality in patients with HF. 23…”