Prognostic value of pleural effusion, CA-125 and NT-proBNP in patients with acute decompensated heart failure.
BACKGROUND
Acute decompensated heart failure (HF) is a serious complication associated with significant morbidity and mortality. The CA-125 and NT-proBNP levels have been shown in some studies to predict the outcome, however, the prognostic value of other simple clinical parameters such as pleural effusion has not been established yet.


OBJECTIVE
To assess the prognostic value of pleural effusion regarding in-hospital and 6-month follow-up outcome in patients with acute decompensated HF and the relationship between pleural effusion and CA-125 and NT-proBNP levels.


RESULTS
The CA-125 and NT-proBNP levels were measured at baseline and the presence of pleural effusion was examined on chest radiograms. One hundred patients were prospectively followed until the occurrence of cardiac death, defined as death from worsening HF or sudden cardiac death, or completion of follow-up period. There were 27 deaths over the course of 6 months of follow-up. An insignificant trend towards higher values of CA-125 was found in patients with pleural effusion. Univariate Cox regression analysis showed that there was no relationship between pleural effusion and in-hospital outcome as well as mortality during 6-month follow-up. The CA-125 and NT-proBNP levels predicted mortality. Multivariate Cox regression analysis showed that only CA-125 was an independent predictor of the 6-month outcome (RR: 1.2; 1.04-1.4; p = 0.001).


CONCLUSIONS
In patients with acute decompensated HF, accompanying pleural effusion did not predict mortality or rehospitalisation during the 6-month follow-up. The increased CA-125 level was found to be an independent predictor of poor outcome, irrespective of pleural effusion.
Davutoglu
Vedat
V
Department of Cardiology, Gaziantep University, Gaziantep, Turkey. davutoglu@gantep.edu.tr
Yildirim
Cuma
C
Kucukaslan
Hasan
H
Yuce
Murat
M
Sari
Ibrahim
I
Tarakcioglu
Mehmet
M
Akcay
Murat
M
Cakici
Musa
M
Ceylan
Nurdan
N
Al
Behcet
B
D000368:Aged; D015415:Biomarkers / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D010996:Pleural Effusion / Q000097:blood* / Q000150:complications / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood; D012044:Regression Analysis; D015996:Survival Rate; D016896:Treatment Outcome
D015415:Biomarkers; D018394:CA-125 Antigen; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain