Author contributions: Mendez AB contributed to design of the study, analysis and interpretation of data, manuscript writing and final approval of manuscript; Ordoñez-Llanos J contributed to analysis of data, review of CA125 and NT-proBNP determinations and substantial contribution to manuscript review; Ferrero A contributed to statistical assessment and substantial contribution to manuscript review; Noguero M contributed to patient selection and follow-up, Serotec and analysis of data; Mir T and Mora J contributed to CA125 and NT-proBNP determinations, analysis of data, substantial contribution to manuscript; Bayes-Genis A and Mirabet S contributed to patient selection and follow-up, analysis of data, substantial contribution to manuscript; Cinca J contributed to design of the study and substantial contribution to manuscript review; Roig E contributed to design of the study, selection of patients, analysis of data, and substantial contribution to manuscript review. Abstract AIM: To study the prognostic value of carbohydrate antigen 125 (CA125) and whether it adds prognostic information to N-terminal pro-brain natriuretic peptide (NT-proBNP) in stable heart failure (HF) patients.
METHODS:The predictive value of CA125 was retrospectively assessed in 156 patients with stable HF remitted to the outpatient HF unit for monitoring from 2009 to 2011. Patients were included in the study if they had a previous documented episode of HF and received HF treatment. CA125 and NT-proBNP concentrations were measured. The independent association between NT-proBNP or CA125 and mortality was assessed with Cox regression analysis, and their combined predictive ability was tested by the integrated discrimination improvement (IDI) index.
RESULTS:The mean age of the 156 patients was 72 ± 12 years. During follow-up (17 ± 8 mo), 27 patients died, 1 received an urgent heart transplantation and 106 required hospitalization for HF. Higher CA125 values were correlated with outcomes: 58 ± 85 KU/L if hospitalized vs 34 ± 61 KU/L if not (P < 0.05), and 94 ± 121 KU/L in those who died or needed urgent heart transplantation vs 45 ± 78 KU/L in survivors (P < 0.01).After adjusting for propensity scores, the highest risk was observed when both biomarkers were elevated vs not elevated (HR = 8.95, 95%CI: 3.11-25.73; P < 0.001) and intermediate when only NT-proBNP was elevated vs not elevated (HR = 4.15, 95%CI: 1.41-12.24; P < 0.01). Moreover, when CA125 was added to the clinical model with NT-proBNP, a 4% (P < 0.05) improvement in the IDI was found.CONCLUSION: CA125 > 60 KU/L identified patients in stable HF with poor survival. Circulating CA125 level adds prognostic value to NT-proBNP level in predicting HF outcomes.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved. Key words: Heart failure; Prognosis; Carbohydrate antigen 125; Brain natriuretic peptides; Survival Core tip: Increased carbohydrate antigen 125 (CA125) has prognostic implications in acute heart failure (HF). The aim of this study was to assess the prognostic value of ...