Clinical Role of CA125 in WorseningHeartFailure: A BIOSTAT-CHF Study Subanalysis.

Autores de INCLIVA

• 

  Julio Nuñez Villota

  Autor

• Gema Miñana Escriva

  Autor

• 

  Vicent Bodí Peris

  Autor

• Agustín Fernández Cisnal

  Autor

• 

  Juan Sanchis Fores

  Autor

Participantes ajenos a INCLIVA

• Bayes-Genis, Antoni
• Revuelta-Lopez, Elena
• Ter Maaten, Jozine M
• Barallat, Jaume
• Cserkoova, Adriana
• Nunez, Eduardo
• Lang, Chim
• Ng, Leong L
• Metra, Marco
• Voors, Adriaan A

Grupos y Plataformas de I+D+i

• Grupo de investigación en Cardiología Clínica

  

  Leading Researcher

  Juan Sanchis Fores

• Grupo de Investigación en Insuficiencia Cardiaca

  

  Established Researcher

  Julio Nuñez Villota

• Grupo de Investigación Traslacional en Cardiopatía Isquémica

  

  Leading Researcher

  Vicent Bodí Peris

Abstract

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.

© 2020 by the American College of Cardiology Foundation published by Elsevier

Keywords

• CA125; carbohydrate antigen 125; congestion; outcome; worsening heart failure