Carbohydrate antigen-125 and N-terminal pro-brain natriuretic peptide levels: compared in heart-failure prognostication

• Published in: Texas Heart Institute journal 2012, Vol.39 (1), p.30-35
• Main Authors: Ordu, Serkan, Ozhan, Hakan, Alemdar, Recai, Aydin, Mesut, Caglar, Onur, Yuksel, Hatice, Kandis, Hayati
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers - blood; CA-125 Antigen - blood; Chi-Square Distribution; Clinical Investigation; Disease-Free Survival; Female; Heart Failure - blood; Heart Failure - diagnosis; Heart Failure - immunology; Heart Failure - mortality; Heart Failure - therapy; Hospitalization; Humans; Kaplan-Meier Estimate; Male; Membrane Proteins - blood; Middle Aged; Multivariate Analysis; Natriuretic Peptide, Brain - blood; Peptide Fragments - blood; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Prospective Studies; Reproducibility of Results; Risk Assessment; Risk Factors; ROC Curve; Time Factors; Turkey
• ISSN: 0730-2347; 1526-6702

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.