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Retrospective cohort study demonstrates that elevated cancer antigen 125 predicts all-cause mortality in heart failure, highlighting its short-term prognostic utility.
Background Cancer Antigen 125 (CA125) is a large transmembrane protein. Previous studies in heart failure have demonstrated that CA125 is associated with measures of vascular congestion, inflammation, and long-term outcome, especially regarding monitoring therapy. The short-term prognostic significance of an increased CA125 in patients presenting with signs and symptoms of heart failure (HF) remains to be elucidated. Aim To determine the short-term prognosis of an increased CA125 in patients presenting with signs and symptoms of HF. Methods A retrospective cohort study was performed using electronic medical records from a global federated research network from the US. The network was searched on 28th December 2023. NTproBNP and CA125 results were the first reported within 30 days of presentation with shortness of breath, or fatigue or ankle oedema. Cohorts were grouped according to biomarker-specific thresholds and 1:1 propensity-score matched for age, gender and co-morbidities (hypertension, diabetes mellitus, hyperlipidaemia, CV procedures and medications, eGFR and smoking status) Patients with ovarian cancer were excluded. Logistical regression produced odds ratios with 95%CI for 30-day and 6 month incident HF and all-cause mortality. All statistical analysis was performed on the network's online platform. Results The results are shown in table 1 (30-day outcome) and table 2 (6 month outcome). Conclusion In our large cohort elevated levels of CA125 do provide prognostic information, especially all-cause mortality. Further validation of CA125 may focus on its use in guiding treatment response, or dynamic modelling to evaluate the prognostic significance of changes in CA125. Conflict of Interest None
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McDowell et al. (2024) studied this question.
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