CA125: an increasingly promising biomarker in heart failure

2021 ◽  
Vol 27 ◽  
Author(s):  
Chunqi Pan ◽  
Mengyun Zhou ◽  
Ying Jian ◽  
Yuanyuan Zeng ◽  
Mingwei Wang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Risk Stratification ◽  
Fluid Overload ◽  
Malignant Tumors ◽  
Promising Candidate ◽  
The Past ◽  
Inflammatory Stimuli ◽  
Echocardiographic Parameters ◽  
Serial Measurements

: CA125 is a well-known tumor marker for diagnosis, monitoring, and risk stratification in ovarian cancer. It is not specific for malignant tumors and may be elevated in benign disease. In the past two decades, increasing evidence has emerged suggesting that the plasma level of CA125 can serve as a novel surrogate of heart failure (HF). CA125 in patients with HF is synthesized by epithelial serous cells in response to both mechanical and inflammatory stimuli. In patients with HF, regardless of etiology, CA125 levels correlate with the severity of clinical, hemodynamic, and echocardiographic parameters and with other biomarkers. Elevated CA125 can identify patients at high risk of rehospitalization and mortality, whether short- or long-term. Serial measurements and combination with different pathophysiology biomarkers can provide more accurate prognosis value. It also can guide treatment due to as a robust biomarker of fluid overload and inflammation, particularly for diuretic dose optimization. These properties make it a very promising candidate for risk stratification and treatment guidance of HF.

scholarly journals Risk Stratification for Heart Failure and Death in an Acute Coronary Syndrome Population Using Inflammatory Cytokines and N-Terminal Pro-Brain Natriuretic Peptide

2007 ◽  
Vol 53 (12) ◽  
pp. 2112-2118 ◽  
Author(s):  
Peter A Kavsak ◽  
Dennis T Ko ◽  
Alice M Newman ◽  
Glenn E Palomaki ◽  
Viliam Lustig ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Risk Stratification ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Troponin I ◽  
Significant Risk ◽  
Risk Of Death ◽  
Coronary Syndrome

Abstract Background: Inflammation in acute coronary syndrome (ACS) can identify those at greater long-term risks for heart failure (HF) and death. The present study assessed the performance of interleukin (IL)-6, IL-8, and monocyte chemoattractant protein-1 (MCP-1) (cytokines involved in the activation and recruitment of leukocytes) in addition to known biomarkers [e.g., N-terminal pro-brain natriuretic peptide (NT-proBNP)] for predicting HF and death in an ACS population. Methods: In a cohort of 216 ACS patients, NT-proBNP (Elecsys®; Roche) and IL-6, IL-8, and MCP-1 (evidence investigator™; Randox) were measured in serial specimens collected early after symptom onset (n = 723). We collected at least 2 specimens from each participant: an early specimen (median 2 h; interquartile range 2–4 h) and a later specimen (9 h; 9–9 h), and used the later specimens’ biomarker concentrations for risk stratification. Results: An increase in both IL-6 and NT-proBNP was observed but not for IL-8 or MCP-1 early after pain onset. Kaplan–Meier analysis demonstrated that individuals with increased NT-proBNP (>183 ng/L) or cytokines (IL-6 > 6.4 ng/L; above upper limit of normal for IL-8 or MCP-1) had a greater probability of death or HF in the following 8 years (P <0.05). In a Cox proportional hazard model adjusted for both CRP and troponin I, increased IL-6, MCP-1, and NT-proBNP remained significant risk factors. Combining all 3 biomarkers resulted in a higher likelihood ratio for death or HF than models restricted to any 2 of these biomarkers. Conclusion: IL-6, MCP-1, and NT-proBNP are independent predictors of long-term risk of death or HF, highlighting the importance of identifying leukocyte activation and recruitment in ACS patients.

scholarly journals Proceedings From the 2019 Stanford Single Ventricle Scientific Summit: Advancing Science for Single Ventricle Patients: From Discovery to Clinical Applications

2020 ◽  
Vol 9 (7) ◽  
Author(s):  
Sushma Reddy ◽  
Stephanie Siehr Handler ◽  
Sean Wu ◽  
Marlene Rabinovitch ◽  
Gail Wright
Keyword(s):  
Heart Failure ◽  
Patient Outcomes ◽  
Single Ventricle ◽  
The United States ◽  
Vascular Abnormalities ◽  
The Past ◽  
Worldwide Population ◽  
Underlying Mechanisms ◽  
Fontan Patients

Abstracts Because of remarkable advances in survival over the past 40 years, the worldwide population of individuals with single ventricle heart disease living with Fontan circulation has grown to ≈70 000, with nearly half aged >18 years. Survival to at least 30 years of age is now achievable for 75% of Fontan patients. On the other hand, single ventricle patients account for the largest group of the 6000 to 8000 children hospitalized with circulation failure, with or without heart failure annually in the United States, with the highest in‐hospital mortality. Because there is little understanding of the underlying mechanisms of heart failure, arrhythmias, pulmonary and lymphatic vascular abnormalities, and other morbidities, there are no specific treatments to maintain long‐term myocardial performance or to optimize overall patient outcomes.

Abstract 15403: Is the Sum Greater Than the Whole? Association of Heart Risk Factors and Echocardiographic Parameters With Reduction in 6-Minute Walk Test in Stage A Heart Failure

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Mark T Nolan ◽  
Ying Wang ◽  
Hilda Yang ◽  
Thomas H Marwick
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Walk Test ◽  
Prior Chemotherapy ◽  
6Mwt Distance ◽  
Significant Difference ◽  
Echocardiographic Parameters ◽  
6 Minute Walk Test ◽  
Minute Walk

Introduction: Chemotherapy increases long-term risk of heart failure (HF), but its impact relative to other HF risk factors is unknown. 6 minute walk test (6MWT) provides prognostic information regarding hospitalization and mortality in HF patients. We sought the relative role of these factors on echocardiographic changes and 6MWT. Hypothesis: Prior chemotherapy is associated with greater functional impairment than other stage A HF risk factors. Methods: We recruited 521 asymptomatic pts from the community aged ¬>65 years with stage A heart failure (SAHF, based on at least one of: diabetes, obesity, hypertension, coronary artery disease or chemotherapy). All went echocardiographic studies and 6MWT. 45 patients had previous chemotherapy (mean interval 7±7.5 years) and underwent 6MWT. These patients were matched 2:1 using demographic and clinical characteristics with patients who did not receive chemotherapy. Fisher’s test and independent t-test were used for statistical analysis. Results: There were no significant difference in demographic variables. The chemotherapy group had a significantly lower 6MWT distance (mean difference -155m) and significantly higher proportion of patients with 6MWT distance < 400m (26.7% vs. 11%, p=0.043). There were no significant difference in other echocardiographic parameters assessing systolic, diastolic and geometrical parameters. Conclusion: Prior chemotherapy has a significant long-term effect on functional capacity in comparison with other SAHF factors. As no one echo parameter was associated with this difference, this could potentially be secondary to noncardiac (including vascular) parameters.

scholarly journals Cancer antigen-125 and outcomes in acute heart failure: a systematic review and meta-analysis

Heart Asia ◽  
2018 ◽  
Vol 10 (2) ◽  
pp. e011044 ◽  
Author(s):  
Ka Hou Christien Li ◽  
Mengqi Gong ◽  
Guangping Li ◽  
Adrian Baranchuk ◽  
Tong Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Risk Stratification ◽  
Acute Heart Failure ◽  
Prognostic Value ◽  
Fluid Overload ◽  
Meta Analysis ◽  
Hospital Readmissions ◽  
Randomised Trial ◽  
Systematic Evaluation ◽  
All Cause Mortality

BackgroundCarbohydrate antigen-125 (CA125) is an ovarian cancer marker, but recent work has examined its role in risk stratification in heart failure. A recent meta-analysis examined its prognostic value in heart failure generally. However, there has been no systematic evaluation of its role specifically in acute heart failure (AHF).MethodsPubMed and EMBASE databases were searched until 11 May 2018 for studies that evaluated the prognostic value of CA125 in AHF.ResultsA total of 129 and 179 entries were retrieved from PubMed and EMBASE. Sixteen studies (15 cohort studies, 1 randomised trial) including 8401 subjects with AHF (mean age 71 years old, 52% male, mean follow-up 13 months, range of patients 525.1±598.2) were included. High CA125 levels were associated with a 68% increase in all-cause mortality (8 studies, HRs: 1.68, 95% CI 1.36 to 2.07; p<0.0001; I2: 74%) and 77% increase in heart failure-related readmissions (5 studies, HRs: 1.77, 95% CI 1.22 to 2.59; p<0.01; I2: 73%). CA125 levels were higher in patients with fluid overload symptoms and signs compared with those without them, with a mean difference of 54.8 U/mL (5 studies, SE: 13.2 U/mL; p<0.0001; I2: 78%).ConclusionOur meta-analysis found that high CA125 levels are associated with AHF symptoms, heart failure-related hospital readmissions and all-cause mortality. Therefore, CA125 emerges as a useful risk stratification tool for identifying high-risk patients with more severe fluid overload, as well as for monitoring following an AHF episode.

scholarly journals Head-to-Head Comparison of 2 Myocardial Fibrosis Biomarkers for Long-Term Heart Failure Risk Stratification

2014 ◽  
Vol 63 (2) ◽  
pp. 158-166 ◽  
Author(s):  
Antoni Bayes-Genis ◽  
Marta de Antonio ◽  
Joan Vila ◽  
Judith Peñafiel ◽  
Amparo Galán ◽  
...  
Keyword(s):  
Heart Failure ◽  
Risk Stratification ◽  
Myocardial Fibrosis ◽  
Failure Risk
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