CA125: a new biomarker in patients with Fontan circulation.

Autor: Buendía Fuentes F; Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Cardiopatías Congénitas del Adulto, Hospital Universitario y Politécnico La Fe, Valencia, Spain. Electronic address: franciscobuendia@svcardio.org., Jover Pastor P; Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain., Arnau Vives MÁ; Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain., Lozano Edo S; Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain., Rodríguez Serrano M; Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain., Aguero J; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain., Osa Sáez A; Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain., Conde Amiel I; Unidad de Hepatología, Servicio Medicina Digestiva, Hospital Universitario y Politécnico La Fe, Valencia, Spain., Aguilera Sancho-Tello V; Unidad de Hepatología, Servicio Medicina Digestiva, Hospital Universitario y Politécnico La Fe, Valencia, Spain., Martínez-Dolz L; Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain., Rueda Soriano J; Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Cardiopatías Congénitas del Adulto, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de cardiologia (English ed.) [Rev Esp Cardiol (Engl Ed)] 2023 Feb; Vol. 76 (2), pp. 112-120. Date of Electronic Publication: 2022 Jul 21.
DOI: 10.1016/j.rec.2022.05.029
Abstrakt: Introduction and Objectives: Patients with Fontan circulation (FC) have a high incidence of clinical complications. However, no biomarker is able to accurately stratify risk. The aim of this study was to analyze the relationship between biomarkers and clinical complications, including carbohydrate antigen 125 (CA125) for the first time, and to propose a risk estimation based on a combination of biomarkers.
Methods: Cross-sectional study of patients with FC. The clinical endpoint was the combination of heart failure, atrial arrhythmias, veno-venous fistulae, protein-losing enteropathy, or plastic bronchitis. Demographic, clinical, and laboratory variables were analyzed, including CA125, NT-proBNP, renal and liver function, and red cell distribution width (RDW). We performed univariate and multivariate analyses of the relationship between these variables and the composite endpoint. Cutoff values were calculated by ROC curves.
Results: We included 56 patients (27.4±7.8 years). A total of 34% showed the composite endpoint, with significantly higher CA125 levels (30.1 IU/mL vs 12.6 IU/mL; P=.001). In the multivariate model, the biomarkers related to the endpoint were LnCA125 (OR, 5.1; 95%CI, 1.2-22), RDW (OR, 1.8; 95%CI, 1.1-3.1), and FIB4 (OR, 38, 95%CI, 1.7-855). The cutoff points were CA125 ≥ 20 U/mL, FIB4 ≥ 0.75, and RDW ≥ 14.5%, and the probability of the occurrence of the endpoint was 81% if ≥ 2 biomarkers were elevated.
Conclusions: CA125 elevation is associated with a higher prevalence of complications in patients with Fontan-type circulation. CA125 levels ≥ 20U/mL, FIB4 ≥ 0.75 and RDW ≥ 14.5% identify with a high probability the clinical failure of FC.
(Copyright © 2022. Published by Elsevier España, S.L.U.)
Databáze: MEDLINE
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