title: [Benefits of statin therapy based on plasma carbohydrate antigen 125 values following an admission for acute heart failure].
abstract: OBJECTIVE
  The prognostic benefit of statins in patients with heart failure is a topic of controversy. Under the hypothesis that statins may provide greater benefit in a subgroup of patients with heightened inflammatory activity, we sought to explore whether statins are associated with a decreased risk of long-term mortality in patients with acute heart failure based on elevated levels of carbohydrate antigen 125, a biomarker related to systemic congestion and proinflammatory status.
  
  
  METHODS
  We analysed 1222 consecutive patients admitted with acute heart failure in a single teaching center during a median follow-up of 20 months. carbohydrate antigen 125 was measured during index hospitalization and dichotomized according to the established reference cut-off (>35 U/mL).
  
  
  RESULTS
  Increased levels of carbohydrate antigen 125 (>35 U/mL) were observed in 793 (64.9%) and prescription of statins registered in 455 (37.2%) patients. In patients with carbohydrate antigen 125 >35 U/mL, mortality was lower in statin-treated patients (1.89 vs 2.80 per 10 patient-years of follow-up, P <.001). Conversely, in those with carbohydrate antigen 125 in normal range, mortality did not differ (1.76 vs 1.63 per 10 patient-years of follow-up, P = .862). After covariate adjustment, this differential effect persisted (P for interaction = .024) and statin use was associated with a significant mortality reduction in patients with elevated values of carbohydrate antigen 125 (hazard ratio=0.65, 95% confidence interval: 0.51-0.82; P <.001), but not in those with values equal to or below 35 U/mL (hazard ratio=1.02, 95% confidence interval: 0.74-1.41; P = .907).
  
  
  CONCLUSIONS
  Elevation of carbohydrate antigen 125 (>35 U/mL) identified a subset of patients with acute heart failure who could benefit from statin treatment in regard to total mortality.
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de Valencia, Valencia, España. yulnunez@gmail.com
authors.forename: Julio
authors.initials: J
authors.lastname: Núñez
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchis
authors.forename: Eduardo
authors.initials: E
authors.lastname: Núñez
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.forename: Vicent
authors.initials: V
authors.lastname: Bodí
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu-González
authors.forename: Gema
authors.initials: G
authors.lastname: Miñana
authors.forename: Patricia
authors.initials: P
authors.lastname: Palau
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fácila
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Chorro
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu-Martínez
authors.forename: Angel
authors.initials: A
authors.lastname: Llàcer
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D018394:CA-125 Antigen / Q000097:blood*; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment
chemical_list: D015415:Biomarkers; D018394:CA-125 Antigen; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors