title: Carbohydrate antigen-125 and N-terminal pro-brain natriuretic peptide levels: compared in heart-failure prognostication.
abstract: Carbohydrate antigen-125 (CA-125) is emerging as a prognostic biomarker of risk in heart failure. In a prospective study, we compared the prognostic values of CA-125 and amino-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with stable heart failure.We enrolled 102 consecutive chronic, stable, systolic-heart-failure patients (68 men and 34 women; median age, 71 yr) from November 2008 through February 2010. We measured baseline NT-proBNP and CA-125 levels and compared their prognostic values. The primary endpoint was all-cause death and other major adverse events, defined as hospitalization for decompensated heart failure or acute coronary syndrome.During a mean follow-up period of 14 ± 2 months, 12 patients died and 35 others sustained major adverse events. We found that CA-125 level significantly correlated with New York Heart Association functional class, pulmonary artery pressure, microalbuminuria, creatine kinase-MB fraction, and hemoglobin, albumin, and NT-proBNP levels. Upon receiver operating characteristic curve analysis, CA-125 and NT-proBNP had similar accuracy in predicting major adverse events and death: for major adverse events, area under the curve (AUC) was 0.699 for CA-125 (P=0.002) and 0.696 for NT-proBNP (P=0.002); for death, AUC was 0.784 for CA-125 (P=0.003) and 0.824 for NT-proBNP (P=0.001). Multivariate Cox regression analysis showed that CA-125 levels greater than 32 U/mL and NT-proBNP levels greater than 5,300 pg/mL had independent prognostic value for major adverse events and death.We conclude that baseline CA-125 and NT-proBNP levels are comparably reliable as heart-failure markers, and that CA-125 can be used for prognosis prediction in heart failure.
authors.affiliation: Department of Cardiology, Duzce Medical School, Duzce University, 81620 Duzce, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Ordu
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozhan
authors.forename: Recai
authors.initials: R
authors.lastname: Alemdar
authors.forename: Mesut
authors.initials: M
authors.lastname: Aydin
authors.forename: Onur
authors.initials: O
authors.lastname: Caglar
authors.forename: Hatice
authors.initials: H
authors.lastname: Yuksel
authors.forename: Hayati
authors.initials: H
authors.lastname: Kandis
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008565:Membrane Proteins / Q000097:blood*; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014421:Turkey
chemical_list: D015415:Biomarkers; D018394:CA-125 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain