Key result
Elevated serum CA125 linked to ~5-fold higher rate of death and CHF hospitalization.
Why the study?
The study aimed to evaluate serum levels of carbohydrate antigen 125 (CA125) in patients with congestive heart failure to understand its relation to disease severity and prognosis.
Does the serum level of CA125 correlate with disease severity and predict mortality or hospitalization in patients with chronic heart failure?
Observational (n=286)
Does the serum level of CA125 correlate with disease severity and predict mortality or hospitalization in patients with chronic heart failure?
Absolute Event Rate: 61.9% vs 12.6%
p-value: p=<0.01
Serum CA125 levels are associated with heart failure severity, hemodynamics, and short-term prognosis, making it a potential biomarker for tracking therapy response and risk stratification.
OBJECTIVES: The aim of this study was to evaluate the serum levels of carbohydrate antigen 125 (CA125) in patients with congestive heart failure (CHF). BACKGROUND: CA125 is a glycoprotein produced by serosal epithelium, found to be increased in ovarian cancer. METHODS: Serum levels of CA125 were obtained in 286 patients (122 males and 164 females; age 69 +/- 13 years) with CHF (left ventricular ejection fraction 30 +/- 11%). A non-invasive evaluation was obtained by Doppler echocardiography; right heart catheterization was performed in 88 patients. An attempt to adjust medical therapy to maximally tolerated doses was done, and CA125 was repeated after 18 days (range 7 to 40) in 80 patients. The mean follow-up duration was 6 +/- 3 months in 240 patients. RESULTS: The mean value of CA125 was 68 +/- 83 U/ml (range 3 to 537): 71 +/- 85 in men and 56 +/- 64 U/ml in women (p = NS). CA125 above the normal value (<35 U/ml) was found in 152 (53%) of 286 patients; it was higher in patients with advanced New York Heart Association (NYHA) functional class (n = 140 in class I/II: 15 +/- 9 U/ml; n = 63 in class III: 57 +/- 18 U/ml; n = 83 in class IV: 167 +/- 94 U/ml; p < 0.005). CA125 was related to the deceleration time of early filling on transmitral Doppler (r = -0.63, p < 0.05) and to pulmonary artery wedge pressure (r = 0.66, p < 0.05) and right atrial pressure (r = 0.69, p < 0.05). During 6 +/- 3 months of follow-up, a combined end point of mortality and CHF hospitalization was observed in 16 of 127 patients with CA125 <35 U/ml, compared with 70 of 113 patients with CA125 >35 U/ml (p < 0.01). After medical treatment optimization, NYHA class decreased by more than one grade in 56 of 80 patients and was unchanged or increased in 24 patients: CA125 decreased from 125 +/- 98 to 53 +/- 61 U/ml (p < 0.001) in the former and changed from 130 +/- 81 to 153 +/- 61 U/ml (p = NS) in the latter. CONCLUSIONS: Our data suggest that CA125 is related to CHF severity and short-term prognosis. Furthermore, fluctuations of CA125 serum levels over time may reflect changes induced by therapy. Therefore, measurements of CA 125 serum levels might be proposed for the serial assessment of CHF patients.
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D’Aloia et al. (2003) conducted an observational in Congestive heart failure (n=286). Elevated CA125 (>35 U/ml) vs. Normal CA125 (<35 U/ml) was evaluated on Combined endpoint of mortality and CHF hospitalization (p=<0.01). Elevated serum CA125 (>35 U/ml) was associated with a higher rate of mortality and CHF hospitalization compared to normal levels (61.9% vs 12.6%; P<0.01) over 6 months of follow-up.
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