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Published on: June 10, 2025
Factors associated with plasma antigen carbohydrate 125 and amino-terminal pro-B-type natriuretic peptide
Gema Miñana1,2, Rafael de la Espriella1, Anna Mollar1
1Cardiology Department, Universitat de Valencia, Spain.
Insights
In acute heart failure, renal dysfunction and ejection fraction impact amino-terminal pro-B-type natriuretic peptide levels. Congestion and tricuspid regurgitation severity predict antigen carbohydrate 125, a marker for right-sided heart failure.
Area of Science:
- Cardiology
- Biomarker Research
- Heart Failure Management
Background:
- Plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) and antigen carbohydrate 125 (CA-125) are linked to adverse outcomes in acute heart failure (AHF).
- CA-125 is proposed as a marker for right-sided heart failure and a proxy for congestion.
- Understanding factors influencing these biomarkers is crucial for AHF management.
Purpose of the Study:
- To identify key factors associated with NT-proBNP levels in AHF patients.
- To determine the primary predictors of CA-125 levels, including echocardiographic right-sided heart failure parameters.
- To validate CA-125 as a marker for congestion and right-sided heart failure.
Main Methods:
- Prospective study of 2949 patients admitted with AHF.
- Multivariable linear regression analysis using NT-proBNP and CA-125 as dependent variables.
- Analysis included echocardiographic parameters, renal function, and clinical data.
Main Results:
- Estimated glomerular filtration rate (eGFR), left ventricle ejection fraction (LVEF), age, and high-sensitivity troponin T were major predictors of NT-proBNP.
- CA-125 was primarily predicted by pleural effusion, tricuspid regurgitation severity, age, NT-proBNP, and peripheral edema.
- eGFR explained 43.7% of NT-proBNP variance; tricuspid regurgitation explained 25.1% of CA-125 variance.
Conclusions:
- Renal dysfunction, LVEF, and age are key determinants of NT-proBNP in AHF.
- Clinical congestion parameters and tricuspid regurgitation severity are significant predictors of CA-125.
- These findings support the utility of CA-125 as a marker for right-sided heart failure and congestion in AHF.
Background:
Plasma amino-terminal pro-B-type natriuretic peptide and antigen carbohydrate 125 levels are positively associated with a higher risk of adverse clinical outcomes in acute heart failure. As a proxy of congestion, antigen carbohydrate 125 has also been proposed as a right-sided heart failure marker. Thus, we aimed to determine in this population the main factors - including echocardiographic right-sided heart failure parameters - associated with antigen carbohydrate 125 and amino-terminal pro-B-type natriuretic peptide.
Methods And Results:
We prospectively included 2949 patients admitted with acute heart failure. Amino-terminal pro-B-type natriuretic peptide and antigen carbohydrate 125 were used as dependent variables in a multivariable linear regression analysis. The mean age of the sample was 73.9±11.1 years; 48.9% were female, 35.8% showed ischaemic aetiology, and 51.6% exhibited heart failure with preserved ejection fraction. The median (interquartile range) for amino-terminal pro-B-type natriuretic peptide and antigen carbohydrate 125 were 4840 (2111-9204) pg/ml and 58 (26-129) U/ml, respectively. In a multivariable setting, and ranked in order of importance (R2), estimated glomerular filtration rate (43.7%), left ventricle ejection fraction (15.1%), age (12.4%) and high-sensitivity troponin T (10.9%) emerged as the most important factors associated with amino-terminal pro-B-type natriuretic peptide. The five main factors associated with antigen carbohydrate 125 were, in order of importance: the presence of pleural effusion (36.8%), tricuspid regurgitation severity (25.1%), age (11.9%), amino-terminal pro-B-type natriuretic peptide (6.5%) and peripheral oedema (4.3%).
Conclusion:
In patients with acute heart failure the main factors associated with amino-terminal pro-B-type natriuretic peptide were renal dysfunction, left ventricle ejection fraction and age. For antigen carbohydrate 125, clinical parameters of congestion and the severity of tricuspid regurgitation were the most important predictors. These results endorse the value of antigen carbohydrate 125 as a useful marker of right-sided heart failure.
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