Key result
CA125 rises ~1.6 U/mL annually in stable Fontan patients, driven primarily by women.
Why the study?
Heart failure monitoring in patients with Fontan circulation is challenging due to unique hemodynamic features, and conventional heart failure biomarkers are not well validated in this population.
Cohort (n=66)
No
In clinically stable adult patients with Fontan circulation, CA125 levels increased significantly over time, particularly in women, while NT-proBNP remained stable, suggesting CA125 may be a useful biomarker for longitudinal monitoring.
CA125 rise in stable Fontan patients should not change practice; leaves open its role as a longitudinal biomarker, especially in women.
Background: Monitoring heart failure in patients with Fontan circulation (FC) remains challenging due to the unique hemodynamic features of this physiology. Conventional heart failure biomarkers are not well validated in this population. We evaluated longitudinal changes in CA125 and NT-proBNP in clinically stable FC patients, with particular attention to sex-based differences.Methods: We performed a retrospective longitudinal study including clinically stable FC outpatients with ≥2 biomarker measurements separated by ≥2 months. Temporal trends of CA125 and NT-proBNP were analyzed using repeated measurements and stratified by sex.Results:Sixty-six outpatients were included, with a median of five determinations per patient. The extracardiac conduit was the most frequent Fontan type (72.7%). Baseline CA125 was 22.73 ± 46.26 U/mL and demonstrated a significant upward trend over time (+1.63 U/mL/year; p=0.008). Baseline NT-proBNP was 165.13 ± 161.62 pg/mL, with a non-significant increase during follow-up (+3.5 pg/mL/year; p=0.163). Baseline CA125 levels did not differ between sexes. During follow-up, CA125 remained stable in men (0.63 U/mL/year; p=0.419) but increased significantly in women (2.75 U/mL/year; p<0.001). NT-proBNP showed no significant sex differences either at baseline or longitudinally.Conclusions: In clinically stable FC patients, CA125 levels increased significantly over time, especially in women. Whereas NT-proBNP exhibited only a modest, non-significant trend. Serial CA125 assessment may enhance risk stratification and facilitate earlier detection of clinical deterioration in FC.
No takes yet. Share an insight, caveat, or question.
Molina et al. (2026) conducted a cohort in Fontan circulation (n=66). Longitudinal follow-up vs. Baseline was evaluated on Temporal evolution of CA125 levels (+1.63 U/mL/year, p=0.008). In clinically stable patients with Fontan circulation, CA125 levels showed a significant upward trend over time (+1.63 U/mL/year), driven primarily by an increase in women, while NT-proBNP remained stable.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: