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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However, there has been no systematic evaluation of its role specifically in acute heart failure (AHF).</p><p><strong>Methods: </strong>PubMed and EMBASE databases were searched until 11 May 2018 for studies that evaluated the prognostic value of CA125 in AHF.</p><p><strong>Results: </strong>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; I<sup>2</sup>: 74%) and 77% increase in heart failure-related readmissions (5 studies, HRs: 1.77, 95% CI 1.22 to 2.59; p<0.01; I<sup>2</sup>: 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; I<sup>2</sup>: 78%).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":"10 2","pages":"e011044"},"PeriodicalIF":0.0000,"publicationDate":"2018-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2018-011044","citationCount":"29","resultStr":"{\"title\":\"Cancer antigen-125 and outcomes in acute heart failure: a systematic review and meta-analysis.\",\"authors\":\"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\",\"doi\":\"10.1136/heartasia-2018-011044\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Carbohydrate antigen-125 (CA125) is an ovarian cancer marker, but recent work has examined its role in risk stratification in heart failure. 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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; I<sup>2</sup>: 78%).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":12858,\"journal\":{\"name\":\"Heart Asia\",\"volume\":\"10 2\",\"pages\":\"e011044\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2018-10-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1136/heartasia-2018-011044\",\"citationCount\":\"29\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart Asia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1136/heartasia-2018-011044\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2018/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart Asia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/heartasia-2018-011044","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2018/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
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。
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.