Revuelta-López Elena, de la Espriella Rafael, Miñana Gema, Santas Enrique, Villar Sandra, Sanchis Juan, Bayés-Genís Antoni, Núñez Julio
Cardiology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain.
CIBER Cardiovascular, Madrid, Spain.
Sci Rep. 2025 Jan 14;15(1):1905. doi: 10.1038/s41598-024-84622-7.
Soluble ST2 (sST2) is released in response to vascular congestion, inflammation, and pro-fibrotic stimuli. In heart failure (HF), elevated levels of sST2 are associated with a higher risk of adverse clinical outcomes. Emerging evidence suggests that carbohydrate antigen 125 (CA125) may act as a ligand that modulates the inflammatory response. We hypothesized that CA125 might be modulating sST2 activity. In a cohort of 160 patients with acute (AHF) and renal dysfunction, we investigated whether the prognostic value of sST2 varies according to CA125 levels. The endpoints were: (a) total cardiovascular and renal hospitalizations and (b) all-cause mortality during follow-up. Cox regression analyses assessed the association between admission sST2 and endpoints across CA125 (≤ 35 vs. > 35 U/ml). This sub-study of the IMPROVE-HF trial shows that sST2 predicted the composite of cardiovascular or renal rehospitalizations when CA125 was elevated (> 35 U/ml) but not when CA125 ≤ 35 U/ml. These results highlight a potential biological interaction between sST2 and CA125, suggesting that CA125 status may refine the prognostic utility of sST2 in AHF. Clinically, these insights could guide personalized risk stratification and management strategies in this high-risk population.
可溶性ST2（sST2）是在血管充血、炎症和促纤维化刺激下释放的。在心力衰竭（HF）中，sST2水平升高与不良临床结局风险较高相关。新出现的证据表明，糖类抗原125（CA125）可能作为一种调节炎症反应的配体。我们假设CA125可能在调节sST2活性。在一个由160例急性心力衰竭（AHF）和肾功能不全患者组成的队列中，我们研究了sST2的预后价值是否根据CA125水平而有所不同。终点为：（a）心血管和肾脏的总住院次数以及（b）随访期间的全因死亡率。Cox回归分析评估了入院时sST2与CA125水平（≤35 vs.＞35 U/ml）下各终点之间的关联。IMPROVE-HF试验的这项子研究表明，当CA125升高（＞35 U/ml）时，sST2可预测心血管或肾脏再次住院的复合结局，但当CA125≤35 U/ml时则不能。这些结果突出了sST2与CA125之间潜在的生物学相互作用，表明CA125状态可能会完善sST2在AHF中的预后效用。在临床上，这些见解可为这一高危人群的个性化风险分层和管理策略提供指导。
