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Modulating Effect of Carbohydrate Antigen 125 on the Prognostic Value of High-Sensitivity C-Reactive Protein in Heart
Enrique Santas1,2, Arancha Martí-Martínez3, Elena Revuelta-López4,5
1Cardiology Department, Hospital Clínico Universitario de Valencia, Instituto de Investigación Sanitaria (INCLIVA), 46010 Valencia, Spain.
Insights
In acute heart failure (HF), elevated carbohydrate antigen 125 (CA125) amplifies the risk of death and rehospitalization associated with high-sensitivity C-reactive protein (hs-CRP) inflammation.
Area of Science:
- Cardiology
- Biomarker Research
- Inflammation Studies
Background:
- Heart failure (HF) involves significant inflammation and congestion.
- Carbohydrate antigen 125 (CA125) is a potential biomarker in HF.
- High-sensitivity C-reactive protein (hs-CRP) is a marker of inflammation.
Purpose of the Study:
- To investigate the modulatory effect of CA125 on inflammation, as indicated by hs-CRP.
- To assess the combined impact of CA125 and hs-CRP on clinical outcomes in acute HF patients.
Main Methods:
- Analysis of 4043 consecutive acute HF patients.
- Measurement of hs-CRP and CA125 levels during hospitalization.
- Application of multivariate Cox regression to evaluate associations with mortality and rehospitalization at 6 months.
Main Results:
- A significant interaction between hs-CRP and CA125 was found for both death and HF rehospitalization.
- hs-CRP predicted increased risk of death and rehospitalization only when CA125 levels were above 35 U/mL.
- hs-CRP was not predictive of outcomes in patients with CA125 levels ≤ 35 U/mL.
Conclusions:
- CA125 levels modulate the association between hs-CRP and clinical outcomes in acute HF.
- Elevated CA125 amplifies the prognostic value of hs-CRP in HF patients.
- CA125 may play a role in amplifying the inflammatory response in heart failure.
Abstract:
Inflammation and congestion are key pathophysiological processes in heart failure (HF). Our aim was to evaluate the potential modulatory effect of carbohydrate antigen 125 (CA125) on inflammation, assessed by high-sensitivity C-reactive protein (hs-CRP). We analyzed a cohort of 4043 consecutive patients in whom hs-CRP and CA125 levels were measured during a hospitalization for acute HF. Multivariate Cox regression models were applied to assess the association between the biomarkers and all-cause mortality and death/HF rehospitalization at 6 months. In multivariable analysis, a significant interaction between hs-CRP and CA125 was observed for both outcomes (p-value for interaction = 0.036 and <0.001, respectively). hs-CRP was significantly associated with an increased risk of death (HR = 1.27; 95% CI 1.16-1.41; p < 0.001) and death/HF rehospitalization (HR = 1.18; 95% CI 1.09-1.28; p < 0.001) if CA125 > 35 U/mL. In contrast, hs-CRP was not predictive of events when CA125 ≤ 35 U/mL. In conclusion, in patients with acute HF, the association between hs-CRP and clinical outcomes was modulated by CA125 levels. hs-CRP was associated with a higher risk of events only in patients with elevated CA125. These findings support a potential modulatory and amplifying role for CA125 in the inflammatory response in HF.
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