Abstract Background Light chain cardiac amyloidosis (AL-CA) is a plasma cell dyscrasia characterized by amyloid deposition in the myocardium, leading to heart failure and poor prognosis. This study aims to explore the prognostic value of carcinoembryonic antigen (CEA) in this patient population. Methods Consecutive patients diagnosed with AL-CA at our heart failure center, between September 2014 and November 2023, with available data were enrolled. According to the tertiles of CEA, patients were divided into three groups: low-level (≤1.64, n = 56), medium-level (1.64–2.71, n = 56), and high-level (≥2.71, n = 56). Kaplan-Meier analysis and Cox proportional hazards models were used to evaluate the association between and the risk of all-cause mortality. Results A total of 168 patients were included, with a mean age of 61.04 years (standard deviation SD: 10.12 years); 62 patients (36.9%) were female, 137 patients (81.5%) were in European modified Mayo 2004 stage III. CEA levels ranged from 0.36 to 10.82 ng/mL, with a median of 2.1 ng/mL. Only 2 of 168 patients (1.2%) had CEA levels exceeding the upper normal limit. Over an average follow-up period of 345 days, 88 patients (52.4%) died. Kaplan-Meier survival analysis revealed that patients with higher CEA levels had worse survival (log-rank test, P=0.021). In multivariable Cox regression analysis, log transferred CEA remained independently associated with the primary outcome, even after full adjustment for age, smoking status, European modified Mayo 2004 stages, and treatment strategies (adjusted HR: 2.48, 95% CI: 1.02–6.04, P0.05). Conclusion In AL-CA patients, CEA levels are largely within the normal reference range. Nevertheless, CEA serves as an independent prognostic marker for all-cause mortality.Kaplan-Meier curve for mortality
Li et al. (Sat,) studied this question.