Yucel H, Kaya H, Zorlu A, Yıldırımlı K, Sancakdar E, Gunes H, Kurt R, Ozgul U, Turgut O O, Yilmaz M B
Department of Cardiology, Cumhuriyet University Medical School, Sivas, Turkey.
Herz. 2015 Apr;40 Suppl 2:119-24. doi: 10.1007/s00059-014-4148-4. Epub 2014 Sep 27.
Elevated cancer antigen 125 (CA-125) levels are associated with cardiopulmonary disorders such as acute and chronic heart failure (HF), coronary artery disease, chronic obstructive pulmonary disease, and atrial fibrillation (AF). The development of atrial fibrillation (AF) is related to morbidity and mortality in patients with HF: therefore, it is important to identify patients with increased risk for development of AF. We investigated whether plasma CA-125 levels in patients with hospitalized systolic HF could predict the development of AF.
A total of 149 consecutive patients with sinus rhythm who were admitted to the emergency department with hospitalized systolic HF were evaluated prospectively. Serum CA-125 levels were obtained after initial stabilization during their hospital stay.
AF developed in 36 (% 24.2) patients during a follow-up period of 22.1 ± 11 months (range 3-61). CA-125 levels were significantly higher in patients who developed AF than in patients with sinus rhythm [99 U/ml (48-172) vs. 47 U/ml (18-108), p = 0.001]. The optimal cut-off level of CA-125 to predict development of AF was found to be > 68.49 U/ml. CA-125 > 68.49 U/ml, left atrial diameter, right ventricular dilatation, moderate to severe mitral and tricuspid regurgitations were found to have prognostic significance in univariate analysis. In a multivariate Cox proportional hazards model with the backward stepwise method, CA-125 > 68.49 U/ml (HR = 2.693, % 95 CI = 1.285-5.641, p = 0.009) and moderate to severe mitral regurgitation (HR = 2.708, % 95 CI = 1.295-5.663, p = 0.008) were associated with an increased risk of new-onset AF after adjustment for variables found to be statistically significant in univariate analysis and correlated with CA-125 level.
CA-125 level is associated with the development of AF in patients with hospitalized systolic HF.
癌抗原125（CA - 125）水平升高与心肺疾病相关，如急慢性心力衰竭（HF）、冠状动脉疾病、慢性阻塞性肺疾病和心房颤动（AF）。心房颤动（AF）的发生与HF患者的发病率和死亡率相关：因此，识别有AF发生风险增加的患者很重要。我们研究了住院收缩性HF患者的血浆CA - 125水平是否能预测AF的发生。
对149例因住院收缩性HF入住急诊科的连续窦性心律患者进行前瞻性评估。在患者住院期间初始病情稳定后获取血清CA - 125水平。
在22.1±11个月（范围3 - 61个月）的随访期内，36例（24.2%）患者发生AF。发生AF的患者CA - 125水平显著高于窦性心律患者[99 U/ml（48 - 172） vs. 47 U/ml（18 - 108），p = 0.001]。发现预测AF发生的CA - 125最佳截断水平>68.49 U/ml。在单因素分析中，CA - 125>68.49 U/ml、左心房直径、右心室扩张、中度至重度二尖瓣和三尖瓣反流具有预后意义。在采用向后逐步法的多因素Cox比例风险模型中，在对单因素分析中发现具有统计学意义且与CA - 125水平相关的变量进行调整后，CA - 125>68.49 U/ml（HR = 2.693，95% CI = 1.285 - 5.641，p = 0.009）和中度至重度二尖瓣反流（HR = 2.708，95% CI = 1.295 - 5.663，p = 0.008）与新发AF风险增加相关。
住院收缩性HF患者的CA - 125水平与AF的发生相关。
