Martí-Martínez Arancha, Núñez Julio, López-Escribano Herminio, Revuelta-López Elena, Mollar Anna, Peiró Marta, Sanchis Juan, Bayés-Genís Antoni, Carratala Arturo, Miró Òscar, Llorens Pere, Herrero-Puente Pablo
Clinical Biochemistry Department, Valencia Clinical Hospital, 46010 Valencia, Spain.
Cardiology Department, Valencia Clinical Hospital, Instituto de Investigación Sanitaria (INCLIVA), 46010 Valencia, Spain.
Biomolecules. 2025 Apr 18;15(4):602. doi: 10.3390/biom15040602.
Acute heart failure (AHF) is a complex syndrome associated with high mortality and hospital readmissions, characterized by volume overload and inflammation. Soluble ST2 (sST2) and antigen carbohydrate 125 (CA125) are emerging biomarkers that reflect these processes and may interact to influence long-term outcomes in AHF patients. This study aims to examine the prognostic relationship between sST2 and CA125 in predicting mortality and heart failure (HF)-related hospitalizations in patients with decompensated heart failure.
In a cohort of 635 patients with AHF, we investigated whether the prognostic value of sST2 varies according to CA125 levels (≤35 vs. >35 U/mL). The endpoints were: (a) time to all-cause death, and (b) the combination of time to death or new HF admission.
This study of EAHFE registry data shows that the association between sST2 and long-term adverse outcomes (mortality and HF hospitalizations) in patients with AHF was differentially influenced by CA125 concentrations (-value for interactions = 0.031 and 0.029, respectively). Higher sST2 was associated with the risk of death and the combined risk of death/HF readmission when CA125 was >35 U/mL [HR = 1.02 (CI 95%: 1.01-1.04), = 0.006 and 1.02 (CI 95%: 1.01-1.03); = 0.013 per increase in 10 ng/mL, respectively], but not when CA125 was ≤35 U/mL.
This study highlights the prognostic interaction between sST2 and CA125 in AHF. Elevated sST2 predicts poor outcomes mainly in patients with high CA125 levels (>35 U/mL), suggesting CA125's role in modulating inflammatory activity in HF. Further research is needed.
急性心力衰竭（AHF）是一种复杂综合征，与高死亡率和再入院率相关，其特征为容量超负荷和炎症。可溶性ST2（sST2）和糖类抗原125（CA125）是新出现的生物标志物，可反映这些过程，且可能相互作用影响AHF患者的长期预后。本研究旨在探讨sST2与CA125在预测失代偿性心力衰竭患者死亡率和心力衰竭（HF）相关住院方面的预后关系。
在一个由635例AHF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（≤35 vs.>35 U/mL）而有所不同。终点为：（a）全因死亡时间，以及（b）死亡或新发HF住院时间的组合。
这项对EAHFE注册数据的研究表明，AHF患者中sST2与长期不良结局（死亡率和HF住院率）之间的关联受到CA125浓度的不同影响（交互作用P值分别为0.031和0.029）。当CA125>35 U/mL时，较高的sST2与死亡风险以及死亡/HF再入院的综合风险相关[HR = 1.02（95%CI：1.01 - 1.04），P = 0.006以及1.02（95%CI：1.01 - 1.03）；每增加10 ng/mL，P = 0.013]，但当CA125≤35 U/mL时则不然。
本研究突出了AHF中sST2与CA125之间的预后相互作用。sST2升高主要在CA125水平高（>35 U/mL）的患者中预测不良结局，提示CA125在调节HF炎症活动中的作用。需要进一步研究。
