Kaya Hakki, Zorlu Ali, Yucel Hasan, Tatlisu Mustafa Adem, Kivrak Tarik, Coskun Abuzer, Yilmaz Mehmet Birhan
Acta Cardiol. 2016 Feb;71(1):61-6. doi: 10.2143/AC.71.1.3132099.
Atrial fibrillation (AF) is a common arrhythmia in heart failure (HF). Recent studies have shown that serum cancer antigen-125 (CA-125) levels are elevated in HF, and high levels of CA-125 in HF patients with sinus rhythm have been shown to be associated with the development of new onset AF. However, the relation between CA-125 levels and the presence of AF in HF is unknown. In this study we investigated whether plasma CA-125 levels in patients with systolic HF could predict the presence of AF.
The study was a retrospective cohort design including 205 stable systolic HF patients who were selected during outpatient clinic visits and who had CA-125 measurement and an electrocardiogram within the last one month before admittance to cardiology clinic. Patients were classified into two groups based on the presence of AF (n = 67) or sinus rhythm (n = 138).
The mean age of the patients was 68 ± 11 years. CA-125 levels were significantly higher in patients with AF than patients with SR [33 (3-273) vs 102 (7-296) U/ml, P < 0.001]. CA-125 level, presence of right ventricular dilatation, pericardial effusion, moderate to severe TR and MR, and left atrial diameter were found to be associated with the presence of AF in univariate analysis. In a multivariate logistic regression model, only the CA-125 level remained associated. Also, according to the ROC curve analysis, the optimal cut-off level of CA-125 for predicting AF was ≥ 91 U/mL with a specificity of 84% and a sensitivity of 54%.
We have shown that the CA-125 levels can be used to predict AF in patients with systolic HF.
心房颤动（AF）是心力衰竭（HF）中常见的心律失常。最近的研究表明，HF患者血清癌抗原125（CA-125）水平升高，并且窦性心律的HF患者中高水平的CA-125已被证明与新发AF的发生有关。然而，HF中CA-125水平与AF存在之间的关系尚不清楚。在本研究中，我们调查了收缩性HF患者的血浆CA-125水平是否可以预测AF的存在。
本研究为回顾性队列设计，纳入205例稳定的收缩性HF患者，这些患者是在门诊就诊时选择的，并且在进入心脏病诊所前的最后一个月内进行了CA-125测量和心电图检查。根据是否存在AF（n = 67）或窦性心律（n = 138）将患者分为两组。
患者的平均年龄为68±11岁。AF患者的CA-125水平显著高于窦性心律患者[33（3 - 273）对102（7 - 296）U/ml，P < 0.001]。在单因素分析中，发现CA-125水平、右心室扩张、心包积液、中度至重度三尖瓣反流和二尖瓣反流以及左心房直径与AF的存在有关。在多因素逻辑回归模型中，只有CA-125水平仍然相关。此外，根据ROC曲线分析，预测AF的CA-125最佳截断水平为≥91 U/mL，特异性为84%，敏感性为54%。
我们已经表明，CA-125水平可用于预测收缩性HF患者的AF。
