Prognostic significance of carbohydrate antigen 125 in stage D heart failure

BACKGROUND: The predictive value of carbohydrate antigen 125 (CA125) has not been examined in stage D heart failure (HF) patients, regardless of left ventricular ejection fraction (LVEF). We sought to quantify the prognostic usefulness in predicting death and HF readmission in this cohort. METHODS: According to CA125 levels above and below the median (65.7 U/ml), 176 stage D HF patients including more than half (50.6%) had LVEF > 40% were divided into 2 groups. RESULTS: A total of 106 (60.2%) deaths and 102 deaths due to the cardiovascular disease were identified. All-cause death/HF readmission and MACE occurred in 157 patients (89.2%) during 18 months (16–20) of follow-up. By the Kaplan–Meier method, subjects with CA125 ≥ 65.7 U/ml exhibited higher 1-year mortality rate (59.3% vs. 31.0%, P < 0.001) and 1-year death/HF rehospitalization rate (94.2% vs. 80.6%, P < 0.001). In univariate Cox analysis, CA125 (categorized) was a significant prognostic factor for all-cause death, cardiovascular mortality, death/HF readmission and MACE. Based on multivariate Cox analysis, elevated CA125 was still significant for all-cause death, cardiovascular mortality, death/HF readmission and MACE. CONCLUSIONS: In stage D HF patients, elevated CA125 levels were highly predictive of all-cause death, cardiovascular mortality, all-cause death/HF readmission and MACE, which can be used for better risk stratification.