癌症抗原125与急性心力衰竭的预后:一项系统回顾和荟萃分析。

Q2 Medicine Heart Asia Pub Date : 2018-10-26 eCollection Date: 2018-01-01 DOI:10.1136/heartasia-2018-011044
Ka Hou Christien Li, Mengqi Gong, Guangping Li, Adrian Baranchuk, Tong Liu, Martin C S Wong, Aaron Jesuthasan, Rachel W C Lai, Jenny Chi Ling Lai, Alex Pui Wai Lee, Antoni Bayés-Genis, Rafael de la Espriella, Juan Sanchis, William K K Wu, Gary Tse, Julio Nuñez
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引用次数: 29

摘要

背景:碳水化合物抗原-125 (CA125)是卵巢癌标志物,但最近的工作已经研究了它在心衰风险分层中的作用。最近的一项荟萃分析检查了它在心力衰竭中的预后价值。然而,尚无系统评价其在急性心力衰竭(AHF)中的作用。方法:检索PubMed和EMBASE数据库,直到2018年5月11日,以评估CA125在AHF中的预后价值。结果:分别从PubMed和EMBASE检索到129篇和179篇文献。纳入16项研究(15项队列研究,1项随机试验),共纳入8401例AHF患者(平均年龄71岁,男性52%,平均随访13个月,患者范围525.1±598.2)。高CA125水平与全因死亡率增加68%相关(8项研究,hr: 1.68, 95% CI 1.36 ~ 2.07;p2: 74%)和心力衰竭相关再入院率增加77%(5项研究,hr: 1.77, 95% CI 1.22至2.59;p2: 73%)。有体液超载症状和体征的患者CA125水平高于无此症状和体征的患者,平均差异为54.8 U/mL(5项研究,SE: 13.2 U/mL;p2: 78%)。结论:我们的荟萃分析发现,高CA125水平与AHF症状、心力衰竭相关的再入院率和全因死亡率相关。因此,CA125可作为一种有用的风险分层工具,用于识别严重体液超载的高危患者,以及AHF发作后的监测。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Cancer antigen-125 and outcomes in acute heart failure: a systematic review and meta-analysis.

Background: Carbohydrate antigen-125 (CA125) is an ovarian cancer marker, but recent work has examined its role in risk stratification in heart failure. A recent meta-analysis examined its prognostic value in heart failure generally. However, there has been no systematic evaluation of its role specifically in acute heart failure (AHF).

Methods: PubMed and EMBASE databases were searched until 11 May 2018 for studies that evaluated the prognostic value of CA125 in AHF.

Results: A total of 129 and 179 entries were retrieved from PubMed and EMBASE. Sixteen studies (15 cohort studies, 1 randomised trial) including 8401 subjects with AHF (mean age 71 years old, 52% male, mean follow-up 13 months, range of patients 525.1±598.2) were included. High CA125 levels were associated with a 68% increase in all-cause mortality (8 studies, HRs: 1.68, 95% CI 1.36 to 2.07; p<0.0001; I2: 74%) and 77% increase in heart failure-related readmissions (5 studies, HRs: 1.77, 95% CI 1.22 to 2.59; p<0.01; I2: 73%). CA125 levels were higher in patients with fluid overload symptoms and signs compared with those without them, with a mean difference of 54.8 U/mL (5 studies, SE: 13.2 U/mL; p<0.0001; I2: 78%).

Conclusion: Our meta-analysis found that high CA125 levels are associated with AHF symptoms, heart failure-related hospital readmissions and all-cause mortality. Therefore, CA125 emerges as a useful risk stratification tool for identifying high-risk patients with more severe fluid overload, as well as for monitoring following an AHF episode.

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Heart Asia
Heart Asia Medicine-Cardiology and Cardiovascular Medicine
CiteScore
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