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High Serum Carbohydrate Antigen (CA) 125 Level Is Associated With Poor Prognosis in Patients With Light-Chain Cardiac
Muzheng Li1, Zhijian Wu1, Ilyas Tudahun1
1Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China.
Insights
High serum carbohydrate antigen 125 (CA 125) levels in light-chain cardiac amyloidosis (AL-CA) patients indicate a poorer prognosis. CA 125 is a novel prognostic predictor, with accuracy comparable to established biomarkers for AL-CA.
Area of Science:
- Cardiology
- Oncology
- Biomarker Research
Background:
- Light-chain cardiac amyloidosis (AL-CA) is associated with elevated serum carbohydrate antigen 125 (CA 125).
- The prognostic significance of CA 125 in AL-CA remains underexplored.
Purpose of the Study:
- To investigate the clinical implications of increased serum CA 125 levels in patients diagnosed with AL-CA.
- To evaluate CA 125 as a prognostic biomarker in AL-CA.
Main Methods:
- A cohort of 95 AL-CA patients was analyzed.
- Serum CA 125 levels were measured and correlated with clinical characteristics, survival, and other biomarkers.
- Multivariate Cox hazard analysis and time-dependent receiver operating characteristic (t-ROC) curves were employed.
Main Results:
- Elevated serum CA 125 was observed in 60% of AL-CA patients.
- High CA 125 levels were associated with polyserositis, higher hemoglobin, serum potassium, LDL-cholesterol, and cardiac troponin T.
- Median overall survival was significantly lower in patients with high CA 125 (5 months vs. 25 months).
- CA 125 and treatment without chemotherapy were independent predictors of mortality.
- CA 125 demonstrated prognostic prediction accuracy comparable to cardiac troponin T, NT-proBNP, and LDH.
Conclusions:
- Serum CA 125 is a novel and valuable prognostic predictor in AL-CA.
- Elevated CA 125 levels are significantly correlated with reduced overall survival in AL-CA patients.
- CA 125 offers prognostic accuracy similar to traditional biomarkers for AL-CA.
Abstract:
Background and Aims: Patients with light-chain cardiac amyloidosis (AL-CA) are characterized by high levels of serum carbohydrate antigen 125 (CA 125). However, studies have not explored the correlation between CA 125 and AL-CA. The aim of this study was to explore the clinical implications of an increase in CA 125 in patients with AL-CA. Methods and Results: A total of 95 patients diagnosed with AL-CA at the Second Xiangya Hospital were enrolled in this study. Out of the 95 patients with AL-CA, 57 (60%) patients had elevated serum CA 125 levels. The mean age was 59.7 ± 10.0 years with 44 (77.2%) men in the high serum CA 125 group, and 61.8 ± 9.6 years with 28 (73.7%) men in the normal group. Patients with high CA 125 showed higher rates of polyserositis (79.3% vs. 60.5%, p = 0.03), higher levels of hemoglobin (117.4 ± 21.9 g/L vs. 106.08 ± 25.1 g/L, p = 0.03), serum potassium (4.11 ± 0.47 mmol/L vs. 3.97 ± 0.40 mmol/L, p = 0.049), low-density lipoprotein-cholesterol (3.0 ± 1.6 mmol/L vs. 2.3 ± 1.10 mmol/L, p = 0.01), and cardiac troponin T (96.0 pg/mL vs. 91.9 pg/mL, p = 0.005). The median overall survival times for patients with high or normal serum CA 125 were 5 and 25 months, respectively (p = 0.045). Multivariate Cox hazard analysis showed that treatment without chemotherapy (HR 1.694, 95% CI 1.121-2.562, p = 0.012) and CA 125 (HR 1.002, 95% CI 1.000-1.004, p = 0.020) was correlated with high all-cause mortality. The time-dependent receiver operating characteristic (t-ROC) curve showed that the prediction accuracy of CA 125 was not inferior to that of cardiac troponin T, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and lactate dehydrogenase (LDH) based on the area under the curve. Conclusions: CA 125 is a novel prognostic predictor. High serum CA 125 values are correlated with low overall survival, and the accuracy of predicting prognosis is similar to that of traditional biomarkers in AL-CA.
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