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Carbohydrate antigen 125 for mortality risk prediction following acute myocardial infarction
Felipe Falcão1,2, Flávio Oliveira3,4, Fabiano Cantarelli3,4
1Departamento de Medicina Interna, Universidade de Pernambuco (UPE), Garanhuns, PE, Brazil. felipejaf@gmail.com.
Insights
Elevated Carbohydrate Antigen 125 (CA125) levels in ST-segment elevation myocardial infarction (STEMI) patients predict a higher risk of 6-month mortality. CA125 shows similar predictive performance to NTproBNP and hs-CRP for STEMI patient outcomes.
Area of Science:
- Cardiology
- Biomarkers
- Clinical Research
Background:
- Carbohydrate antigen 125 (CA125) is a known biomarker for congestion and inflammation, linked to poorer outcomes in heart disease.
- The prognostic value of elevated CA125 in ST-segment elevation myocardial infarction (STEMI) requires further investigation.
Purpose of the Study:
- To determine the association between CA125 levels and 6-month all-cause mortality in patients with STEMI.
- To compare the predictive performance of CA125 against established biomarkers like NT-proBNP and hs-CRP in STEMI.
Main Methods:
- A consecutive cohort of 245 STEMI patients undergoing coronary angioplasty had CA125, NT-proBNP, and hs-CRP levels measured.
- All-cause mortality was assessed at 6 months post-admission.
- Receiver operating characteristic (ROC) curve analysis was used to evaluate predictive performance.
Main Results:
- The 6-month all-cause mortality rate was 18% (44 patients).
- Elevated CA125 (≥11.48 U/ml) was associated with a significantly higher mortality rate (Hazard Ratio = 2.07, p=0.017).
- CA125 demonstrated comparable predictive performance for mortality to NT-proBNP and hs-CRP.
Conclusions:
- Elevated CA125 levels can identify STEMI patients at increased risk of 6-month mortality.
- CA125 serves as a valuable prognostic biomarker in STEMI, similar to NT-proBNP and hs-CRP.
Abstract:
Carbohydrate antigen 125 (CA125) is a congestion and inflammation biomarker and has been proved to be related to a worse prognosis in heart diseases. However, the precise relationship between elevated CA125 in patients with ST-segment elevation myocardial infarction (STEMI) has not yet been sufficiently studied. We set out to determine the association of CA125 with all-cause mortality at 6 months in STEMI. CA125, N-terminal pro brain natriuretic peptide (NTproBNP) and high sensitive C-reactive protein (hs-CRP) were measured in 245 patients admitted consecutively with STEMI undergoing coronary angioplasty. The mean age in our sample was 63.7 years, 64.9% were males, 28.3% had diabetes and 17.7% presented with acute heart failure (Killip ≥ 2). The median serum level of CA125 was 8.1 U/ml. At 6 months, the rate of all-cause mortality was 18% (44 patients). Receiver operating characteristic curve analysis demonstrated that CA125 presented similar performance to predict mortality as NTproBNP and hs-CRP. Patients with CA125 ≥ 11.48 had a higher rate of mortality (Hazard Ratio = 2.07, 95% confidence interval = 1.13-3.77, p = 0.017) than patients with CA125 < 11.48. This study suggests that elevated CA125 levels might be used to identify patients with STEMI with a higher risk of death at 6 months. CA125 seems to be a similar predictor of mortality compared to NTproBNP and hs-CRP.
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