Carbohydrate antigen 125 concentrations across the ejection fraction spectrum in chronic heart failure: The EMPEROR
João Pedro Ferreira1,2,3, Milton Packer4,5, Naveed Sattar6
1Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Cardiovascular Research and Development Center (UnIC@RISE), Porto, Portugal.
European Journal of Heart Failure
|March 5, 2024
Summary
Carbohydrate antigen 125 (CA-125) is not a reliable biomarker for congestion in chronic heart failure (HF). However, elevated CA-125 levels may predict adverse outcomes in patients with heart failure with reduced ejection fraction (HFrEF).
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure
Background:
- Vascular congestion is a known factor that can elevate carbohydrate antigen 125 (CA-125) levels.
- The prognostic value of CA-125 in chronic heart failure (HF) across the ejection fraction (EF) spectrum is not well-established.
Purpose of the Study:
- To investigate the association between CA-125 and congestion in patients with chronic heart failure (HF).
- To evaluate CA-125 as a prognostic biomarker for cardiovascular outcomes in HF patients with varying ejection fractions (EF).
Main Methods:
- Serum CA-125 levels were analyzed in 1111 participants from the EMPEROR-Reduced and EMPEROR-Preserved trials.
- Cox regression models assessed the relationship between CA-125 tertiles and the composite outcome of HF hospitalization or cardiovascular death.
- Congestive signs and symptoms were evaluated across CA-125 tertiles.
Main Results:
- No significant association was found between baseline CA-125 levels and congestive signs or symptoms.
- Higher CA-125 levels were associated with an increased risk of the primary outcome in heart failure with reduced ejection fraction (HFrEF) but not in heart failure with preserved ejection fraction (HFpEF).
- Elevated CA-125 levels correlated with a faster decline in estimated glomerular filtration rate.
Conclusions:
- CA-125 is not a significant biomarker for congestion in the majority of chronic HF patients studied.
- CA-125 may serve as a prognostic indicator for HF hospitalization or cardiovascular death in HFrEF patients, but not in HFpEF patients.
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