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Published on: June 10, 2025
Carbohydrate antigen 125 (CA125) as a prognostic marker in the elderly with acute heart failure and preserved
Pau Llàcer1, Julio Núñez2, Luis Manzano3
1Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, España.
Insights
Elevated CA125 levels in older adults with acute heart failure and preserved ejection fraction predict higher mortality risk within one year. Low CA125 identifies a low-risk subgroup for heart failure readmissions.
Area of Science:
- Cardiology
- Biomarkers
- Geriatrics
Background:
- Carbohydrate antigen 125 (CA125) is a novel biomarker for heart failure.
- Acute heart failure with preserved ejection fraction (AHF) affects elderly populations.
- Predictive value of CA125 in this demographic requires further investigation.
Purpose of the Study:
- To assess if serum CA125 levels predict one-year total mortality.
- To determine if serum CA125 levels predict one-year readmissions for AHF.
- To investigate these associations in patients over 70 with AHF and PEF.
Main Methods:
- A multicenter prospective observational study.
- Included 359 patients aged over 70 years (mean age 81.5).
- Negative binomial regression analyzed CA125 association with mortality and readmissions.
Main Results:
- One-year mortality was 24.2% (87 deaths).
- Elevated CA125 showed a significant positive association with increased mortality risk (p=0.009).
- Association with readmission risk was positive but not statistically significant (p=0.089).
Conclusions:
- In elderly patients with AHF and PEF, high CA125 levels correlate with increased one-year mortality.
- Low CA125 levels identify a subgroup with a lower risk of mortality.
- The association between CA125 and AHF readmission risk is uncertain.
Background:
Carbohydrate antigen 125 (CA125) has emerged as a new biomarker in heart failure. The objective of the study is to determine whether serum CA125 levels predict total mortality and readmissions at one year in patients >70 years old with acute heart failure (AHF) and preserved ejection fraction (PEF).
Methods:
Multicenter prospective observational study, which included 359 patients (mean age 81.5 years). The primary endpoint was total all-cause mortality and total readmissions for AHF at 1 year. A negative binomial regression technique was used to evaluate the association between CA125 and both endpoints.
Results:
At one year of follow-up, 87 deaths (24.2%) were registered. The patients in the lower quartile of CA125 had a lower crude mortality rate (14.4%, 26.7, 26.7, 29.2; p=0.09). After multivariate analysis, the CA125 value was positively associated with a higher risk (p=0.009). Such association was also positive but borderline significant for the risk of readmissions (p=0.089).
Conclusions:
In a population older than 70 years hospitalized for AHF with PEF, elevated levels of CA125 are associated with an increased risk of death at one year of follow-up. The association with readmission for AHF was more uncertain. Low levels of CA125 identifies a subgroup at low-risk.
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