Inflammatory activation and carbohydrate antigen‐125 levels in subjects with atrial fibrillation

Gennaro, Luisa De; Brunetti, Natale Daniele; Montrone, Deodata; Rosa, Fiorella De; Cuculo, Andrea; Biase, Matteo Di

doi:10.1111/j.1365-2362.2011.02592.x

Cited by 34 publications

(24 citation statements)

References 26 publications

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“…9,43,46 The most commonly reported group of these cytokines [47][48][49][50] has also been implicated in the pathogenesis of the set of comorbidities identified in our analysis to predict severe acute GVHD. [51][52][53][54][55][56][57][58][59][60][61] In particular, higher pretransplant levels of soluble IL-2 receptor a chain and interleukin-18 were correlated with severity of Figure 2. Kaplan Meier estimates of overall survival.…”

Section: Org Frommentioning

confidence: 92%

Pretransplant comorbidities predict severity of acute graft-versus-host disease and subsequent mortality

Sorror

Martin

Storb

et al. 2014

Blood

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• The HCT-CI stratifies patients into 3 groups for risks of grades 3 to 4 GVHD regardless of conditioning intensity, donor, or graft types.• Comorbidity burden and development of grades 2 to 4 acute GVHD have cumulative effects on mortality rates.Whether the hematopoietic cell transplantation comorbidity index (HCT-CI) can provide prognostic information about development of acute graft-versus-host disease (GVHD) and subsequent mortality is unknown. Five institutions contributed information on 2985 patients given human leukocyte antigen-matched grafts to address this question. Proportional hazards models were used to estimate the hazards of acute GVHD and post-GVHD mortality after adjustment for known risk variables. Higher HCT-CI scores predicted increased risk of grades 3 to 4 acute GVHD (P < .0001 and c-statistic of 0.64), and tests of interaction suggested that this association was consistent among different conditioning intensities, donor types, and stem cell sources. Probabilities of grades 3 to 4 GVHD were 13%, 18%, and 24% for HCT-CI risk groups of 0, 1 to 4, and ‡5. The HCT-CI was statistically significantly associated with mortality rates following diagnosis of grade 2 (hazard ratio [HR] 5 1.24; P < .0001) or grades 3 to 4 acute GVHD (HR 5 1.19; P < .0001).Patients with HCT-CI scores of ‡3 who developed grades 3 to 4 acute GVHD had a 2.63-fold higher risk of mortality than those with scores of 0 to 2 and did not develop acute GVHD. Thus, pretransplant comorbidities are associated with the development and severity of acute GVHD and with post-GVHD mortality. The HCT-CI could be useful in designing trials for GVHD prevention and could inform expectations for GVHD treatment trials. (Blood. 2014;124(2):287-295)

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Section: Org Frommentioning

confidence: 92%

Pretransplant comorbidities predict severity of acute graft-versus-host disease and subsequent mortality

Sorror

Martin

Storb

et al. 2014

Blood

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“…In studies related to HF, CA-125 values correlated with pulmonary artery pressure, pulmonary artery capillary wedge pressure, left atrial volume index, LVEF, brain natriuretic peptide values, New York Heart Association functional class, and pericardial effusion. 14,15,17 In our study, CA-125 values correlated with SPAP, LVEF, and pericardial effusion.…”

Section: Discussionmentioning

confidence: 76%

“…It is not surprising, therefore, to find that AF, in the current study, is an independent predictor for prolonged hospitalization in patients with HF. 14,17,19,43,44 In addition to high CA-125 levels and the presence of AF, lower sodium levels and higher creatinine levels are associated with prolonged LOS. This result, consistent with previous studies, is not surprising.…”

Section: Discussionmentioning

confidence: 99%

“…The prolongation of hospitalization through the use of positive inotropic agents is an expected result, yet prolonged hospitalization in the absence of β-blockers and diuretics could arise from poor clinical conditions or poor prognosis. Recent studies 12,[14][15][16] have shown that CA-125, long useful as a tumor marker, has prognostic importance in many cardiovascular diseases, especially HF. In studies related to HF, CA-125 values correlated with pulmonary artery pressure, pulmonary artery capillary wedge pressure, left atrial volume index, LVEF, brain natriuretic peptide values, New York Heart Association functional class, and pericardial effusion.…”

Section: Discussionmentioning

confidence: 99%

“…11 However, in the last decade, a correlation between serum CA-125 levels and cardiopulmonary diseases such as left-and rightsided HF, coronary artery disease, atrial fibrillation (AF), and chronic obstructive pulmonary disease (COPD), has been revealed. [12][13][14][15][16][17][18][19] Although serum CA-125 levels are significantly increased in HF and this increase correlates with the severity of the disease, the relationship between CA-125 and length of stay (LOS) in patients with HF has not yet been evaluated. This study is the first that attempts to evaluate the relationship between the duration of hospitalization and CA-125 levels in patients with HF.…”

mentioning

confidence: 99%

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Cancer Antigen 125 is Associated with Length of Stay in Patients with Acute Heart Failure

Kaya¹,

Kurt²,

Beton³

et al. 2017

Texas Heart Institute Journal

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Length of stay is the primary driver of heart-failure hospitalization costs. Because cancer antigen 125 has been associated with poor morbidity and mortality rates in heart failure, we investigated the relationship between admission cancer antigen 125 levels and lengths of stay in heart-failure patients. A total of 267 consecutive patients (184 men, 83 women) with acute decompensated heart failure were evaluated prospectively. The median length of stay was 4 days, and the patients were classified into 2 groups: those with lengths of stay ≤4 days and those with lengths of stay >4 days. Patients with longer lengths of stay had a significantly higher cancer antigen 125 level of 114 U/mL (range, 9–298 U/mL) than did those with a shorter length of stay (19 U/mL; range; 3–68) (P <0.001). The optimal cutoff level of cancer antigen 125 in the prediction of length of stay was >48 U/mL, with a specificity of 95.8% and a sensitivity of 96% (area under the curve, 0.979; 95% confidence interval [CI], 0.953–0.992). In the multivariate logistic regression model, cancer antigen 125 >48 U/mL on admission (odds ratio=4.562; 95% CI, 1.826–11.398; P=0.001), sodium level (P<0.001), creatinine level (P=0.009), and atrial fibrillation (P=0.015) were also associated with a longer length of stay after adjustment for variables found to be statistically significant in univariate analysis and correlated with cancer antigen 125 level. In addition, it appears that in a cohort of patients with acute decompensated heart failure, cancer antigen 125 is independently associated with prolonged length of stay.

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Carbohydrate antigen 125 concentrations across the ejection fraction spectrum in chronic heart failure: The EMPEROR programme

Ferreira,

Packer,

Sattar

et al. 2024

European J of Heart Fail

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AimVascular congestion may lead to an increase of carbohydrate antigen 125 (CA‐125). The role of CA‐125 as a biomarker of congestion or for prognosis across the full ejection fraction (EF) spectrum of chronic heart failure (HF) remains unknown.Methods and resultsSerum CA‐125 was measured in 1111 study participants from the EMPEROR‐Reduced and EMPEROR‐Preserved trials. Congestive signs and symptoms were evaluated across CA‐125 tertiles. Cox regression was used to study the association with outcomes. The primary outcome was a composite of first HF hospitalization or cardiovascular (CV) death. No significant association was present between baseline CA‐125 levels and congestive signs or symptoms. In the overall population, higher CA‐125 levels were not associated with an increased risk of primary outcome (tertile 3 vs. tertile 1: hazard ratio [HR] 1.34; 95% confidence interval [CI] 0.91–1.96; p‐trend = 0.11). However, higher CA‐125 levels were associated with an increased risk of primary outcome in patients with HF and reduced EF (HFrEF; tertile 3 vs. tertile 1: HR 2.25 [95% CI 1.30–3.89]), but not among patients with preserved EF (HFpEF; tertile 3 vs. tertile 1: HR 0.68 [95% CI 0.38–1.21]); interaction‐p = 0.02). Patients in the upper CA‐125 tertile also showed the steepest estimated glomerular filtration rate decline over time (p‐trend = 0.03). The effect of empagliflozin to reduce the risk of CV death or HF hospitalization appeared to be attenuated in those with lower baseline CA‐125 levels (interaction‐p‐trend = 0.09).ConclusionAcross the range of EF in patients with chronic HF enrolled in the EMPEROR trials, the majority of whom did not have clinical evidence of congestion, CA‐125 concentrations were not significantly associated with congestive signs or symptoms. CA‐125 concentrations may predict HF hospitalization/CV death in patients with HFrEF, but not those with HFpEF.Clinical Trial Registration: EMPEROR‐Reduced (NCT03057977), EMPEROR‐Preserved (NCT03057951).

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Inflammatory activation and carbohydrate antigen‐125 levels in subjects with atrial fibrillation

Abstract: AF is characterised by an inflammatory activation. Impaired functional class in AF subjects might be associated with increased CA-125 levels and higher inflammatory markers.

Cited by 34 publications

References 26 publications

Pretransplant comorbidities predict severity of acute graft-versus-host disease and subsequent mortality

Pretransplant comorbidities predict severity of acute graft-versus-host disease and subsequent mortality

Cancer Antigen 125 is Associated with Length of Stay in Patients with Acute Heart Failure

Carbohydrate antigen 125 concentrations across the ejection fraction spectrum in chronic heart failure: The EMPEROR programme

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