Carbohydrate antigen-125: additional accuracy in identifying patients at risk of acute heart failure in acute coronary syndrome.
OBJECTIVE
To evaluate levels of carbohydrate antigen-125 (CA-125) in patients with acute coronary syndrome (ACS), with regard to incidence of acute heart failure (AHF) and levels of brain natriuretic peptide (BNP).


METHODS
In 47 consecutive patients with ACS, circulating levels of CA-125 and BNP were ascertained in the first 24 h and after 3 days of hospitalization. Left ventricular function and in-hospital incidence of AHF were also evaluated.


RESULTS
BNP and CA-125 levels were significantly higher in patients with pulmonary oedema (PO) (564.25+/-500.50 vs. 258.57+/-284.81 pg/ml, P<0.05; 51.78+/-54.71 vs. 13.78+/-12.01 UI/ml, P<0.001) proportionally to Killip class (r=0.44, r=0.47; P<0.01) and were related to LV end-diastolic dimension (r=0.47, P<0.01; r=0.66, P<0.001) and LV ejection fraction (r=-0.63, P<0.001; r=-0.37, P<0.01). CA-125 levels identified patients with PO with higher specificity (97.1 vs. 31.4%), positive predictive value (83.3 vs. 33.3%) and accuracy (83.0 vs. 48.9%) when compared with BNP.


CONCLUSIONS
CA-125 levels are increased in patients with ACS and systolic dysfunction or AHF. Patients with PO are better identified by combined BNP and CA-125 assay rather than by only BNP.
Department of Cardiology, University of Foggia, Foggia, Italy.
Luisa
L
De Gennaro
Natale Daniele
ND
Brunetti
Rosa
R
Bungaro
Deodata
D
Montrone
Andrea
A
Cuculo
Pier Luigi
PL
Pellegrino
Michele
M
Correale
Matteo
M
Di Biase
D054058:Acute Coronary Syndrome / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000097:blood*; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011237:Predictive Value of Tests; D011654:Pulmonary Edema / Q000097:blood / Q000209:etiology; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D013997:Time Factors; D015854:Up-Regulation; D016277:Ventricular Function, Left
D015415:Biomarkers; D018394:CA-125 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins; D020097:Natriuretic Peptide, Brain