Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, China.
BMC Surg. 2023 Aug 9;23(1):225. doi: 10.1186/s12893-023-02099-z.
Cancer antigen-125 (CA-125), a tumor marker, has received increasing attention in recent years for its role in the cardiovascular field. However, no study has reported the association of CA-125 with early postoperative atrial fibrillation (POAF) after heart valve surgery. Therefore, the aim of this study was to assess whether there is a correlation between CA-125 and early postoperative POAF after heart valve surgery.
Patients who underwent valve surgery at Fujian Heart Medical Center from January 2020 to August 2022 were retrospectively analyzed and divided into postoperative atrial fibrillation group (POAF group) and postoperative non-atrial fibrillation group (NO-POAF), and the differences in clinical data between the two groups were compared, and the variables with statistical significance in the univariate analysis were included in the COX regression analysis, and finally the receivers' operating characteristics (ROC) curves were drawn.
From January 2020 to August 2022, a total of 1653 patients underwent valve surgery. A total of 344 patients were finally included, including 52 patients (15.1%) in the POAF group and 292 patients (84.9%) in the NO-POAF group. Univariate analysis showed higher CA-125 levels in patients in the POAF group than in those in the NO-POAF group [27.89 (13.64, 61.54), 14.48 (9.87, 24.08), P = 0.000]. Analysis of the incidence of POAF based on CA-125 quartiles showed an incidence of up to 29.2% in the highest quartile (> 27.88). Multivariate COX regression analysis showed that CA-125 [OR = 1.006, 95% CI (1.002, 1.010), P = 0.001] was an independent predictor of POAF. The final ROC curve plot showed that the area under the curve for CA-125 was 0.669, with an optimal cut-off value of 27.08 U/ml, and the difference in the area under the curve between the two groups was statistically significant (P = 0.000).
Elevated preoperative CA-125 levels can affect the incidence of POAF and have a predictive value for the occurrence of POAF in the early stage after valve surgery. However, due to the small sample size and single-center retrospective study, further validation of this result is needed.
肿瘤标志物癌抗原 125（CA-125）在心血管领域的作用近年来受到越来越多的关注。然而，尚无研究报道 CA-125 与心脏瓣膜手术后早期心房颤动（POAF）之间的关系。因此，本研究旨在评估 CA-125 是否与心脏瓣膜手术后早期 POAF 相关。
回顾性分析 2020 年 1 月至 2022 年 8 月在福建医科大学附属协和医院接受瓣膜手术的患者，分为术后心房颤动组（POAF 组）和术后非心房颤动组（NO-POAF 组），比较两组间的临床资料差异，对单因素分析中具有统计学意义的变量进行 COX 回归分析，最终绘制受试者工作特征（ROC）曲线。
2020 年 1 月至 2022 年 8 月共 1653 例患者接受瓣膜手术，最终共纳入 344 例患者，其中 POAF 组 52 例（15.1%），NO-POAF 组 292 例（84.9%）。单因素分析显示 POAF 组患者的 CA-125 水平高于 NO-POAF 组[27.89（13.64，61.54）比 14.48（9.87，24.08），P=0.000]。基于 CA-125 四分位数的 POAF 发生率分析显示，最高四分位数（>27.88）的发生率高达 29.2%。多因素 COX 回归分析显示，CA-125[比值比（OR）=1.006，95%置信区间（CI）（1.002，1.010），P=0.001]是 POAF 的独立预测因子。最终的 ROC 曲线显示，CA-125 的曲线下面积为 0.669，最佳截断值为 27.08 U/ml，两组间曲线下面积差异有统计学意义（P=0.000）。
术前 CA-125 水平升高可影响 POAF 的发生率，对瓣膜手术后早期 POAF 的发生具有预测价值。但由于本研究样本量较小且为单中心回顾性研究，需要进一步验证该结果。
