No abstract

Background. CA-125 is a tumor antigen expressed on the surface of ovarian cells, used to monitor the treatment of ovarian cancer (normal upper limit is 35U/mL), but it seems also to have a role as biomarker in heart failure (HF).Aim. To determine CA-125 changes in acute-decompensated HF (ADHF) patients.Method. The study group included 110 patients (mean age 72±10 years, 63% men) with ADHF caused by ischemic cardiomyopathy. The subjects were clinically, ecocardiographically and biologically (NT-proBNP, PCR, serum uric acid (sUA), CA-125) evaluated.Results. CA-125 at admission was 53±33 U/mL and decreased at discharge to 34±17 U/mL, without any difference between males and females. The mean level of CA-125 was significantly higher in patients with pleural effusion.There was a significant difference between NT-proBNP at admission in obese versus normoponderal patients, which was maintained at discharge. In the same time, the CA-125 did not show significant differences between obese and normoponderal subjects at admission and discharge. The mean level of CA-125 was significantly higher for subjects with reduced ejection fraction and with elevated left ventricular filling pressures versus subjects with preserved ejection fraction and normal left ventricular filling pressures.The CA-125 correlated with LVEF (R=-0.221, p=0.02), with NT-proBNP (R=0.371, p<0.001), with the inflammation marker - PCR (R=0.284, p=0.003) and oxidative stress marker - sUA (R=0.234, p=0.015).Conclusions. The wide availability of CA-125, its relatively low cost, its correlation with known prognostic markers in HF and the additional information provided make it a valuable biomarker that can be used in monitoring ADHF patients.

Background. It is well known that the NT-proBNP in obese subjects is much lower than in normal weight subjects, making difficult to interpret it. In current practice the patients are frequently obese. In these conditions, a new biomarker, not influenced by weight, could be useful in acute-decompensated heart failure (ADHF).Aim. To determine CA-125 changes in obese and normal weight patients with ADHF.Method. The study group included 110 patients (mean age 72±10 years, 63% men) with ADHF caused by ischemic cardiomyopathy. The subjects were clinically, ecocardiographically and biologically (NT-proBNP, CA-125) evaluated.Results. The mean BMI was 27.6±5.8 kg/m2 and 35 (33%) subjects were obese. CA-125 at admission was 53±33 U/mL and decreased at discharge to 34±17 U/mL, without any difference between males and females.There was a significant difference between NT-proBNP at admission in obese versus normoponderal patients (3207±1432 pg/mL versus 4457±2737 pg/mL (p=0.02)), which was maintained at discharge (1711±816 pg/mL versus 2674±1475 pg/mL (p=0.03)).In the same time, the CA-125 did not show statistically significant differences between obese and normoponderal subjects at admission (56±29 U/mL versus 51±20 U/mL (p=0.63)) and discharge (36±20 U/mL versus 33±16 U/mL (p=0.56)).Conclusions. CA-125 could be an useful biomarker in monitoring the obese patients with ADHF, better than NT-proBNP.

Giant cell arteritis (GCA), or temporal arteritis, is the most common systemic vasculitis, and the greatest risk factor for developing GCA is aging. The disease almost never occurs before age 50, and its incidence rises steadily thereafter, peaking between ages 70 to 79, the risk of development being two times higher in women.Polymialgia rheumatica (PMR) is an inflammatory rheumatic condition characterized clinically by aching and morning stiffness at the shoulders, hip girdle, and neck. PMR is almost exclusively a disease of adults over the age of 50, with a prevalence that increases progressively with advancing age. The peak incidence of PMR occurs between ages 70 and 80, the same as in the case ofGCA. PMRis 2-3 times more common in women than in men.PMR is two to three times more common than GCA and occurs in about 50% of patients with GCA. The percentage of patients with PMR who experience GCA at some point varies widely in reported series ranging from 5 to 30 percent. PMR can precede, accompany or follow GCA. The diagnostic in the case of PMR is made first of all on clinical features, in the patients in whom another disease to explain the findings is not present. For GCA we must follow the diagnostic algorithm presented below (figure 1) and keep in mind that a negative result for temporal artery biopsy does not exclude the diagnostic if clinical suspicion of GCA is highWe present the case of a 81 year-old male with signs and symptoms from both conditions, PMR and GCA.