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Serum CA125: a prognostic biomarker for mortality in chronic heart failure
Ruzeguli Tuersun1, Aihaidan Abudouwayiti1, Yan Xiao Li1
1Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, 137 Carp Road, Xinshi District, Urumqi, 830054, Xinjiang, China.
Insights
Elevated serum Carbohydrate Antigen 125 (CA125) levels are linked to higher long-term mortality in patients with Chronic Heart Failure (CHF). This biomarker shows particular prognostic value in the heart failure with preserved ejection fraction (HFpEF) subgroup.
Area of Science:
- Cardiology
- Biomarker Research
- Clinical Medicine
Background:
- Chronic Heart Failure (CHF) is a significant cause of morbidity and mortality worldwide.
- Identifying reliable prognostic biomarkers is crucial for managing CHF patients.
- Carbohydrate Antigen 125 (CA125) is a known marker, but its role in CHF mortality requires further investigation.
Purpose of the Study:
- To investigate the association between serum CA125 levels and long-term mortality in patients diagnosed with CHF.
- To evaluate the predictive capability of CA125 as a biomarker for mortality risk in CHF.
- To analyze CA125 levels across different CHF subtypes based on ejection fraction.
Main Methods:
- Retrospective cohort study involving 1,413 CHF patients with available CA125 measurements.
- Patients categorized into Heart Failure with reduced (HFrEF), mildly reduced (HFmrEF), and preserved (HFpEF) ejection fraction groups.
- Survival analysis using Kaplan-Meier and Cox proportional hazards regression models.
Main Results:
- Elevated CA125 levels significantly correlated with increased all-cause mortality (ACM) across all CHF subtypes (HR=2.05).
- The association was particularly strong in the HFpEF subgroup (HR=2.32).
- CA125 demonstrated moderate predictive accuracy (AUC=0.655) for ACM, with levels ≥20.8 U/mL indicating higher risk.
Conclusions:
- Serum CA125 levels show potential as a prognostic biomarker for mortality in CHF patients.
- The prognostic value of CA125 is especially notable in the HFpEF subgroup.
- Further research is warranted to confirm these findings and explore underlying pathophysiological mechanisms.
Objective:
To examine the relationship between serum Carbohydrate Antigen 125 (CA125) levels and long-term mortality in Chronic Heart Failure (CHF) patients and to assess its predictive value as a biomarker.
Methods:
This was a retrospective cohort study. We reviewed the medical records of 4,442 consecutive patients admitted to the First Affiliated Hospital of Xinjiang Medical University with a diagnosis of CHF since July 2012. After applying inclusion and exclusion criteria, 1,413 patients with available CA125 level measurements were included. The patients were categorized into three groups based on ejection fraction: HFrEF, HFmrEF, and HFpEF. Demographic details, comorbidities, and laboratory parameters were collected. CA125 levels were measured using an automated chemiluminescent immunoassay. Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards regression.
Results:
The median follow-up was 22.75 months. Elevated CA125 levels were significantly associated with increased all-cause mortality (ACM) across all CHF subtypes (HR = 2.05, 95% CI: 1.60-2.64, P < 0.001), especially in the HFpEF group (HR = 2.32, 95% CI: 1.59-3.40, P < 0.001). The area under the ROC curve for CA125 was 0.655, indicating moderate predictive accuracy. Multivariate analysis revealed that patients with CA125 levels ≥ 20.8 U/mL had a significantly higher risk of ACM (HR = 2.05). Adjustments for confounding factors did not alter these findings.
Conclusion:
Our findings suggest that serum CA125 levels may serve as a potential prognostic biomarker for mortality in CHF patients, particularly in the HFpEF subgroup. However, further research is needed to confirm these findings and elucidate the underlying mechanisms.
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