Long-term serial kinetics of N-terminal pro B-type natriuretic peptide and carbohydrate antigen 125 for mortality risk prediction following acute heart failure

Núñez, Julio; Núñez, Eduardo; Bayés‐Genís, Antoni; Fonarow, Gregg C.; Miñana, Gema; Bodı́, Vicent; Pascual-Figal, Domingo A.; Santas, Enrique; García‐Blas, Sergio; Chorro, Francisco J.; Rizopoulos, Dimitris; Sanchís, Juan

doi:10.1177/2048872616649757

Cited by 53 publications

(63 citation statements)

References 39 publications

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“…We found that the initiation of acetazolamide in this cohort of patients with refractory CHF, who were already on a vigorous diuretic regimen, is feasible and is associated to an improvement in functional class and a decrease in surrogates of congestion. Interestingly, we found a consistent reduction in traditional markers of decongestion such as weight, and on plasma levels of CA125, a glycoprotein that has shown to be closely related with symptoms and signs of fluid overload and its changes over time strongly related with the risk of mortality . In addition, we found an improvement in surrogates of renal function and no evidence of alarming incidence on safety issues such as detriment effect in electrolytes and acid‐base homeostasis.…”

Section: Discussionsupporting

confidence: 58%

“…Interestingly, we found a consistent reduction in traditional markers of decongestion such as weight, and on plasma levels of CA125, a glycoprotein that has shown to be closely related with symptoms and signs of fluid overload and its changes over time strongly related with the risk of mortality. 9 In addition, we found an improvement in surrogates of renal function and no evidence of alarming incidence on safety issues such as detriment effect in electrolytes and acid-base homeostasis.…”

Section: Discussionmentioning

confidence: 59%

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Use of acetazolamide in the treatment of patients with refractory congestive heart failure

Núñez

Heredia

Payá

et al. 2018

Cardiovascular Therapeutics

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 59%

Use of acetazolamide in the treatment of patients with refractory congestive heart failure

Núñez

Heredia

Payá

et al. 2018

Cardiovascular Therapeutics

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“…Nunez et al [21] showed that the simultaneous increase in the values of CA125 and NT-proBNP was associated with the highest risk of mortality due to acute HF and that the increase of the value of one marker was also related to the indirect risk. Mendez et al [22] suggested that the value of CA125 over 60 U/L (higher than the upper range of normal values) may identify patients in chronic HF with poor outcome.…”

Section: Discussionmentioning

confidence: 99%

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

Bulska-Będkowska

Chełmecka

Owczarek

et al. 2019

JCM

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(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.

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“…Additionally, there are some clinical applications beyond risk stratification that deserve to be commented. First, changes over time of this biomarker have shown to be congruent with clinical status and prognosis, suggesting the utility of glycoprotein for disease monitoring during the first months following a hospitalisation 38. Second, a recent clinical trial showed that a CA125-guided therapy in patients with AHF, mostly by modifying diuretic treatment, was superior to conventional therapy in reducing the primary endpoint of composite death and HF readmission at 1-year follow-up 22.…”

Section: Discussionmentioning

confidence: 99%

Cancer antigen-125 and outcomes in acute heart failure: a systematic review and meta-analysis

Li¹,

Gong

et al. 2018

Heart Asia

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BackgroundCarbohydrate antigen-125 (CA125) is an ovarian cancer marker, but recent work has examined its role in risk stratification in heart failure. A recent meta-analysis examined its prognostic value in heart failure generally. However, there has been no systematic evaluation of its role specifically in acute heart failure (AHF).MethodsPubMed and EMBASE databases were searched until 11 May 2018 for studies that evaluated the prognostic value of CA125 in AHF.ResultsA total of 129 and 179 entries were retrieved from PubMed and EMBASE. Sixteen studies (15 cohort studies, 1 randomised trial) including 8401 subjects with AHF (mean age 71 years old, 52% male, mean follow-up 13 months, range of patients 525.1±598.2) were included. High CA125 levels were associated with a 68% increase in all-cause mortality (8 studies, HRs: 1.68, 95% CI 1.36 to 2.07; p<0.0001; I2: 74%) and 77% increase in heart failure-related readmissions (5 studies, HRs: 1.77, 95% CI 1.22 to 2.59; p<0.01; I2: 73%). CA125 levels were higher in patients with fluid overload symptoms and signs compared with those without them, with a mean difference of 54.8 U/mL (5 studies, SE: 13.2 U/mL; p<0.0001; I2: 78%).ConclusionOur meta-analysis found that high CA125 levels are associated with AHF symptoms, heart failure-related hospital readmissions and all-cause mortality. Therefore, CA125 emerges as a useful risk stratification tool for identifying high-risk patients with more severe fluid overload, as well as for monitoring following an AHF episode.

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Long-term serial kinetics of N-terminal pro B-type natriuretic peptide and carbohydrate antigen 125 for mortality risk prediction following acute heart failure

Abstract: The combination of long-term longitudinal trajectories of CA125 and NT-proBNP improves risk stratification for all-cause mortality after a hospitalization for AHF.

Cited by 53 publications

References 39 publications

Use of acetazolamide in the treatment of patients with refractory congestive heart failure

Use of acetazolamide in the treatment of patients with refractory congestive heart failure

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

Cancer antigen-125 and outcomes in acute heart failure: a systematic review and meta-analysis

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