CA125-Guided Diuretic Treatment Versus Usual Care in Patients With Acute Heart Failure and Renal Dysfunction

Núñez, Julio; Llàcer, Pau; García‐Blas, Sergio; Bonanad, Clara; Ventura, Silvia Mastrolembo; Núñez, José María; Sánchez, Ruth; Fácila, Lorenzo; Espriella, Rafael de la; Vaquer, Juana María; Cordero, Alberto; Roqué, Mercè; Chamorro, C.; Bodı́, Vicent; Valero, Ernesto; Santas, Enrique; Moreno, María del Carmen Heredia; Miñana, Gema; Carratalá, Arturo; Rodríguez, Enrique; Mollar, Anna; Palau, Patricia; Bosch, María José; Bertomeu-González, Vicente; Lupón, Josep; Navarro, Jorge; Chorro, Francisco J.; Górriz, José Luis; Sanchís, Juan; Voors, Adriaan A.; Bayés‐Genís, Antoni

doi:10.1016/j.amjmed.2019.07.041

Cited by 79 publications

(69 citation statements)

References 29 publications

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“…In patients with AHF and renal dysfunction at presentation, CA125‐guided intravenous diuretic therapy resulted in better renal performance at 72 h and 30 days. This treatment strategy also improved the global visual analogue scale score and decreased the risk of adverse clinical endpoints at 30 days . Although further research is warranted to confirm the utility of CA125 for tailoring decongestive treatment in AHF, these two trials shed some end‐of‐the‐tunnel light on biomarker‐guided strategies in AHF ( Figure ).…”

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confidence: 89%

“…More recently, the same team reported the results of the IMPROVE-HF (a randomized controlled trial of CA125-guided diuretic treatment vs. usual care in patients with AHF and renal dysfunction) trial. 17 In patients with AHF and renal dysfunction at presentation, CA125-guided intravenous diuretic therapy resulted in better renal performance at 72 h and 30 days. This treatment strategy also improved the global visual analogue scale score and decreased the risk of adverse clinical endpoints at 30 days.…”

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confidence: 98%

“…This treatment strategy also improved the global visual analogue scale score and decreased the risk of adverse clinical endpoints at 30 days. 17 Although further research is warranted to confirm the utility of CA125 for tailoring decongestive treatment in AHF, these two trials shed some end-of-the-tunnel light on biomarker-guided strategies in AHF (Figure 1). Other biomarkers such as high-sensitivity troponins 18 and soluble ST2, 19 both well-known predictors of ventricular remodelling and worse outcome in AHF, have not yet been tested in therapy guidance trials.…”

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confidence: 98%

“…This effect was mainly driven by significant reduction of the rate of rehospitalization. More recently, the same team reported the results of the IMPROVE‐HF (a randomized controlled trial of CA125‐guided diuretic treatment vs. usual care in patients with AHF and renal dysfunction) trial . In patients with AHF and renal dysfunction at presentation, CA125‐guided intravenous diuretic therapy resulted in better renal performance at 72 h and 30 days.…”

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confidence: 99%

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Biomarker‐guided management in acute heart failure: is there light at the end of the tunnel?

Bayés‐Genís

Emdin

Núñez

2019

European J of Heart Fail

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confidence: 89%

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confidence: 98%

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confidence: 98%

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confidence: 99%

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Biomarker‐guided management in acute heart failure: is there light at the end of the tunnel?

Bayés‐Genís

Emdin

Núñez

2019

European J of Heart Fail

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“…This study was performed between March 2015 and December 2016 at 9 centers in Spain. A detailed description of trial design, procedures, and findings are presented elsewhere [8,9].…”

Section: Study Populationmentioning

confidence: 99%

Early Spot Urinary Sodium and Diuretic Efficiency in Acute Heart Failure and Concomitant Renal Dysfunction

et al. 2020

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Objective: In acute heart failure (AHF), early assessment of spot urinary sodium (U Na) has emerged as a useful biomarker for risk stratification and monitoring. The objective of this study was to investigate (a) whether early spot U Na predicts 24-h diuretic efficiency and (b) the clinical factors associated with early spot U Na in patients with AHF and concomitant renal dysfunction (RD). Methods: This is a post hoc analysis of the IMPROVE-HF trial, in which 160 patients with AHF and RD (estimated glomerular filtrate rate [eGFR] < 60 mL/min/1.73 m 2) were included. Diuretic efficiency was calculated as the net fluid output produced per 40 mg of furosemide equivalents in 24 h. The association between early spot U Na and diuretic efficiency and clinical variables associated with U Na were evaluated using multivariate linear regression analysis. The contribution of the exposures in the predictability of the models was assessed with the coefficient of determination (R 2). Results: The mean age of the study population was 78 ± 8 years. The median (interquartile range) diuretic efficiency, early spot U Na , aminoterminal pro-brain

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Antigen carbohydrate 125 as a biomarker in heart failure: a narrative review

Núñez

Espriella

Miñana

et al. 2021

European J of Heart Fail

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104

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Congestion explains many of the signs and symptoms of acute heart failure (AHF) and disease progression. However, accurate quantification of congestion is challenging in daily practice. Antigen carbohydrate 125 (CA125) or mucin 16 (MUC16), a large glycoprotein synthesized by mesothelial cells, has emerged as a reliable proxy of congestion and inflammation in patients with heart failure (HF). In AHF syndromes, CA125 is strongly associated with right‐sided HF parameters and a higher risk of adverse clinical events beyond standard prognostic factors, including natriuretic peptides. Furthermore, CA125 has the potential for both monitoring and guide HF treatment following a decompensated HF event. The wide availability of CA125 in most clinical laboratories, together with its standardized measurement and reduced cost, makes this marker attractive for routine use in decompensated HF. Further research is required to understand better its biological role and its promising utility as a tool to guide decongestive therapy in HF.

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CA125-Guided Diuretic Treatment Versus Usual Care in Patients With Acute Heart Failure and Renal Dysfunction

Cited by 79 publications

References 29 publications

Biomarker‐guided management in acute heart failure: is there light at the end of the tunnel?

Biomarker‐guided management in acute heart failure: is there light at the end of the tunnel?

Early Spot Urinary Sodium and Diuretic Efficiency in Acute Heart Failure and Concomitant Renal Dysfunction

Antigen carbohydrate 125 as a biomarker in heart failure: a narrative review

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