Download Prognostic value of CA 125 in mild to moderate heart failure patients

Prognostic value of CA 125 in mild to moderate heart failure patients
E Vizzardi1, N Pezzali1, A. D’Aloia1, G.Faden1, M Metra1, L Dei Cas1
1Section
of Cardiovascular Diseases, Department of Experimental and Applied Medicine, University and Hospital Brescia, Italy
Purpose
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Plasma levels of tumoral carbohydrate 125 antigen marker (CA 125) have been found
elevated among patients (pts) with heart failure (HF).
They relate to clinical condition and to diastolic and systolic left ventricle(LV)
parameters, as previously observed.
Also, CA125 has already been found to independently be related to mortality among
acute and advanced HF pts.
Results
•During the follow-up, 16 (15.68%) cardiovascular deaths and 23 (22.54%) cardiovascular
deaths+hospitalizations occurred.
•15 (14.7%) pts showed CA125 levels >30 U/ml (established cut-off value).
•Considering cardiac death, comparison of Kaplan Meyer survival curves by the logrank test showed
We evaluated the prognostic value of CA125 in a population of pts with mild to moderate
HF.
that:
• pts with CA125 levels higher than the cut-off value had a worse survival vs the others (p<0.0001,
Methods
Serum levels of CA 125 were obtained in 102 pts with mild to moderate HF due to idiopathic
(48%) or ischemic (52%) dilated cardiomyopathy (age 64+10.6 years left ventricular ejection
fraction (LVEF), 34.36 + 8.54%, NYHA class 2+0.3,) under optimized medical therapy according
to the guidelines (ACE inhibitors-ARBs 95 %, BB 86%).
All the pts underwent a complete clinical examination and transthoracic echocardiography.
Events occurring in a mean 1380.4±487.5 days follow-up were recorded.
HR 0.01722 among pts with CA125 levels lower than the cut-off value, 95% CI 0.003173-0.09344).
•This was observed also when considering cardiovascular death+hospitalizations as the end-point
(p=0.0003, HR 0.07248 among the pts with CA125 lower than the cut-off value, 95% CI 0.017230.3049).
•Moreover, pts with CA125 levels equal or higher than 75% percentile showed a worse survival vs
the other quartiles groups, with a higher incidence of cardiac deaths as well as cardiovascular
death+hospitalizations (p<0.0001).
Conclusions: In mild-to-moderate HF pts under optimized therapy, higher plasma CA 125 levels are
an effective prognostic marker in forecasting cardiovascular events and hospitalization and may
contribute to a better risk stratification.