title: Insights into the clinical implications of carbohydrate antigen 125 as a biomarker of heart failure: a meta-analysis and systematic review of published studies.
abstract: OBJECTIVE
  An increasing number of clinical studies have explored the possibility of using tumor biomarker carbohydrate antigen 125 (CA 125) in the management of patients with heart failure. This systematic review and meta-analysis was performed to comprehensively summarize the available evidence and evaluate the applicability of CA 125 in heart failure.
  
  
  METHODS
  We searched PubMed, Embase, and Cochrane Central Register of controlled trials. Of the 253 studies identified, 23 studies investigating the application of CA 125 in the clinical management of heart failure were included for meta-analyses and systematic review.
  
  
  RESULTS
  The serum levels of CA 125 increased significantly in heart failure patients compared with healthy controls (standardized mean difference of 1.49 U/ml, P < 0.001). The fluctuation of CA 125 was closely associated with echocardiographic parameters. Likewise, the CA 125 levels were positively correlated with brain natriuretic peptide and N-terminal pro-BNP. Further investigation found that CA 125 levels increased accordingly as cardiac function declined from the New York Heart Association class I/II to class III and further from class III to IV [1.58, 95% confidence interval (0.75-2.41) and 1.37, 95% confidence interval (0.76-1.98) U/ml, respectively]. Heart failure patients with poor outcomes showed higher CA 125 level relative to those without adverse effects in short-term or long-term follow-up.
  
  
  CONCLUSIONS
  CA 125 is a promising biomarker in the diagnosis, stratification, and outcome evaluation of heart failure patients. CA 125 may be regarded as a surrogate marker of echocardiographic variables, N-terminal pro-BNP and brain natriuretic peptide.
authors.affiliation: aDepartment of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China bCardiology Division, Spedali Civili and University of Brescia, Brescia, Italy cDepartment of Geriatrics, the 113th Hospital of Chinese People's Liberation Army, Ningbo, China dSection of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy eDepartment of Blood Transfusion, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China *Jianhui Zhuang and Pompilio Faggiano contributed equally to the writing of the study.
authors.forename: Jianhui
authors.initials: J
authors.lastname: Zhuang
authors.forename: Pompilio
authors.initials: P
authors.lastname: Faggiano
authors.forename: Qi
authors.initials: Q
authors.lastname: Li
authors.forename: Danitza
authors.initials: D
authors.lastname: Pradelli
authors.forename: Vet
authors.initials: V
authors.lastname: Med
authors.forename: Wenhui
authors.initials: W
authors.lastname: Peng
authors.forename: Mei
authors.initials: M
authors.lastname: Zuo
authors.forename: Yawei
authors.initials: Y
authors.lastname: Xu
mesh_terms: D015415:Biomarkers / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008565:Membrane Proteins / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D018394:CA-125 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins