Serum levels of carbohydrate antigen 125 in combination with N-terminal pro-brain natriuretic peptide in patients with acute decompensated heart failure

• Main Authors: Jae Yong Yoon, Dong Heon Yang, Hyun Jun Cho, Nam Kyun Kim, Chang-Yeon Kim, Jihyun Son, Jae-Hyung Roh, Se Yong Jang, Myung Hwan Bae, Jang Hoon Lee, Hun Sik Park, Yongkeun Cho, Shung Chull Chae
• Format: Article
• Language: English
• Published: The Korean Association of Internal Medicine 2019-07-01
• Series: The Korean Journal of Internal Medicine
• Subjects: ca-125; natriuretic peptides; heart failure; mortality
• Online Access: http://www.kjim.org/upload/pdf/kjim-2017-313.pdf

Background/Aims Carbohydrate antigen 125 (CA-125) is an emerging prognostic biomarker for heart failure. We aimed to test the long-term prognostic value of CA-125 in combination with N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with acute decompensated heart failure (ADHF). Methods This observational study included a total of 413 patients (64.1 ± 15.6 yearold, 214 men) with ADHF. All-cause mortality during the 2-year follow-up was investigated for the prognosis. Results During the follow-up (mean follow-up, 591 ± 233 days), 109 deaths (26.0%) were recorded. In the multivariable analysis model, CA-125 was an independent factor associated with all-cause mortality (log CA-125: hazard ratio, 1.23; 95% confidence interval, 1.02 to 1.48; p = 0.030) together with age, sex, New York Heart Association class, β-blocker, and NT-proBNP. The Kaplan-Meier survival analysis demonstrated that the group with both low marker levels showed the best 2-year survival (87.9%) followed by the group with low NT-proBNP and high CA-125 (76.1%), high NT-proBNP and low CA-125 (64.7%) and high NT-proBNP and high CA-125 levels (54.3%) (p < 0.001). Addition of CA-125 in combination with NT-proBNP and established risk factors further increased the predictive power for mortality in patients with ADHF. Conclusions CA-125 was an independent factor associated with all-cause mortality in patients with ADHF. Combination of CA-125 with NT-proBNP significantly improved the prediction of mortality in patients with ADHF.