TY - JOUR
T1 - Cancer antigen-125 and outcomes in acute heart failure
T2 - A systematic review and meta-analysis
AU - Li, Ka Hou Christien
AU - Gong, Mengqi
AU - Li, Guangping
AU - Baranchuk, Adrian
AU - Liu, Tong
AU - Wong, Martin C.S.
AU - Jesuthasan, Aaron
AU - Lai, Rachel W.C.
AU - Lai, Jenny Chi Ling
AU - Lee, Alex Pui Wai
AU - Bayés-Genis, Antoni
AU - De La Espriella, Rafael
AU - Sanchis, Juan
AU - Wu, William K.K.
AU - Tse, Gary
AU - Nuñez, Julio
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Background Carbohydrate 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). Methods PubMed and EMBASE databases were searched until 11 May 2018 for studies that evaluated the prognostic value of CA125 in AHF. Results A 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; I 2: 74%) and 77% increase in heart failure-related readmissions (5 studies, HRs: 1.77, 95% CI 1.22 to 2.59; p<0.01; I 2: 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; I 2: 78%). Conclusion Our 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.
AB - Background Carbohydrate 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). Methods PubMed and EMBASE databases were searched until 11 May 2018 for studies that evaluated the prognostic value of CA125 in AHF. Results A 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; I 2: 74%) and 77% increase in heart failure-related readmissions (5 studies, HRs: 1.77, 95% CI 1.22 to 2.59; p<0.01; I 2: 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; I 2: 78%). Conclusion Our 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.
KW - heart failure
KW - heart failure treatment
KW - systolic heart failure
UR - http://www.scopus.com/inward/record.url?scp=85057716321&partnerID=8YFLogxK
U2 - 10.1136/heartasia-2018-011044
DO - 10.1136/heartasia-2018-011044
M3 - Article
AN - SCOPUS:85057716321
VL - 10
JO - Heart Asia
JF - Heart Asia
IS - 2
M1 - e011044
ER -