title: Carbohydrate-antigen-125 levels predict hospital stay duration and adverse events at long-term follow-up in Takotsubo cardiomyopathy.
abstract: The aim of this study is to evaluate the possible role of carbohydrate-antigen(CA)-125 as prognostic marker at short- and long-term follow-up, in subjects with Takotsubo cardiomyopathy (TTC). Sixty-three consecutive subjects with TTC were enrolled in the study and followed for a median 139 days. Circulating levels of CA-125, NT-proBNP, and left ventricular ejection fraction (LVEF) were evaluated at admission. Duration of hospital stay, incidence of death, re-hospitalization and recurrence of TTC during follow-up were recorded. The mean hospital stay was 8.3 days, adverse events occurred during follow up in 17 % of cases. CA-125 levels at admission are inversely related to LVEF (r -0.30, p < 0.05) and directly related to hospital stay (r 0.29, p < 0.05). CA-125 levels at admission are higher in subjects with adverse events at follow-up (88.9 ± 200.0 vs 20.9 ± 30.0 U/mL, p < 0.05). Rates of incidence of adverse events are proportionally increased with CA-125 tertiles (0, 6, 11 % respectively, p for trend <0.01), at survival analysis (Log Rank p < 0.05) and after correction for age, gender, LVEF and NT-proBNP levels in multivariable Cox analysis (p < 0.05). CA-125 levels <10 U/ml are predictors of adverse events at follow up with 91 % sensitivity, 52 % specificity, 29 % positive predictive power, and 96 % negative predictive power. Increased CA-125 admission levels are associated with a longer hospital stay, a lower LVEF, and a higher risk of adverse events during follow up. CA-125 might be useful for early risk stratification of subjects with TTC.
authors.affiliation: Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Santoro
authors.affiliation: Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy.
authors.forename: Armando
authors.initials: A
authors.lastname: Ferraretti
authors.affiliation: Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Musaico
authors.affiliation: Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Martino
authors.affiliation: Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Tarantino
authors.affiliation: Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ieva
authors.affiliation: Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Di Biase
authors.affiliation: Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy. natale.brunetti@unifg.it.
authors.forename: Natale Daniele
authors.identifier: http://orcid.org/0000-0001-9610-7408
authors.initials: ND
authors.lastname: Brunetti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D018394:CA-125 Antigen / Q000032:analysis / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D063868:Patient Outcome Assessment; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000401:mortality*
chemical_list: D015415:Biomarkers; D018394:CA-125 Antigen; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Carbohydrate antigen 125; NT-pro brain natriuretic peptide; Prognosis; Risk stratification; Takotsubo cardiomyopathy
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