Clinical Role of CA125 in Worsening Heart Failure A BIOSTAT-CHF Study Subanalysis
OBJECTIVES: The aim of this study was to evaluate the association between antigen carbohydrate 125 (CA125) and the risk of 1-year clinical outcomes in patients with worsening heart failure (HF).; BACKGROUND: CA125 is a widely available biomarker that is up-regulated in patients with acute HF and has...
| Authors: | , , , , , , , , , , , , , , |
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| Format: | article |
| Status: | Published version |
| Publication Date: | 2020 |
| Country: | España |
| Institution: | INCLIVA |
| Repository: | r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA |
| OAI Identifier: | oai:incliva.fundanetsuite.com:p4287 |
| Online Access: | https://incliva.portalinvestigacion.com/publicaciones/4287 |
| Access Level: | Open access |
| Keyword: | CA125 carbohydrate antigen 125 congestion outcome worsening heart failure |
| Summary: | OBJECTIVES: The aim of this study was to evaluate the association between antigen carbohydrate 125 (CA125) and the risk of 1-year clinical outcomes in patients with worsening heart failure (HF).; BACKGROUND: CA125 is a widely available biomarker that is up-regulated in patients with acute HF and has been postulated as a useful marker of congestion and risk stratification.; METHODS: In a large multicenter cohort of patients with worsening HF, either in-hospital or in the outpatient setting, the independent associations between CA125 and 1-year death and the composite of death/HF readmission (adjusted for outcome-specific prognostic risk score [BIOSTAT risk score]) were determined by using the Royston-Parmar method (N=2,356). In a sensitivity analysis, the prognostic implications of CA125 were also adjusted for a composite congestion score (CCS). Data were validated in the BIOSTAT-CHF (Biology Study to Tailored Treatment in Chronic HeartFailure validation) cohort (N=1,630).; RESULTS: Surrogates of congestion, such as N-terminal pro-B-type natriuretic peptide and CCS, emerged as independent predictors of CA125. In multivariable survival analyses, higher CA125 was associated with an increased risk of mortality and the composite of death/HF readmission (p<0.001 for both comparisons), even after adjustment for the CCS (p<0.010 for both comparisons). The addition of CA125 to the BIOSTAT score led to a significant risk reclassification for both outcomes (category-free net reclassification improvement=0.137 [p<0.001] and 0.104 [p=0.003] respectively). All outcomes were confirmed in an independent validation cohort.; CONCLUSIONS: In patients with worsening HF, higher levels of CA125 were positively associated with parameters of congestion. Furthermore, CA125 remained independently associated with a higher risk of clinical outcomes, evenbeyonda predefined risk model and clinical surrogates of congestion. Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
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