Pourfaraji Seyed Morteza, Shirmard Fatemeh Ojaghi, Salabat Dorsa, Salabat Danyal, Mehdipournamdar Zahra, Kuno Toshiki, Harrison Anil, Samsky Marc, Hosseini Kaveh
Cardiovascular Diseases Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Student Research Committee, Arak University of Medical Sciences, Arak, Iran.
BMC Cardiovasc Disord. 2025 Aug 28;25(1):637. doi: 10.1186/s12872-025-05141-5.
Carbohydrate Antigen 125 (CA125) has emerged as a potential biomarker in patients with heart failure (HF). This meta-analysis comprehensively evaluates the association between CA125 levels and clinical outcomes across HF populations.
We conducted this study based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). We systematically searched PubMed, Scopus, Web of Science, and Embase libraries up to April 2025. We selected the original English-language investigations that reported the association between CA125 levels and clinical outcomes in cases with HF. The random-effects model and Hartung-Knapp-Sidik-Jonkman method were used to pool effect sizes and report summary statistics. The current review was registered in PROSPERO (CRD420251023141).
A total of 20,458 cases were included from 29 studies, with an average age of 70.3 years, and 36.1% of cases were women. The average cut-off level was 37.78 U/mL, and 35 U/mL was mainly used as the CA125 cut-off level. A meta-analysis of nine studies that reported the risk of experiencing endpoint events (death or HF-related hospitalization) showed significantly higher risk (HR 2.23, 95% CI 1.69-2.93; p < 0.01; I = 75.0%) among the patients with higher CA125 levels compared to those with lower levels. The increased risk remained significant across the acute heart failure (AHF) (HR based on two studies: 1.88, 95% CI 1.54-2.30; p < 0.01; I = 39.6%) and chronic heart failure (CHF) (HR based on seven studies: 2.52, 95% CI 1.69-3.77; p < 0.01; I = 77.4%) subgroups. Furthermore, a correlation meta-analysis of 13 studies revealed a significant direct correlation between CA125 and pro-BNP levels (r = 0.42; 95% CI 0.30 to 0.54; p < 0.01; I = 96.9%).
The current review findings revealed CA125 as a significant prognostic factor of mortality and hospitalization risks in HF population. Furthermore, CA125 could be a non-invasive and operator-independent tool for evaluating disease severity and monitoring response to therapy. We suggested CA125 for monitoring various treatments in individuals with HF, specifically diuretic therapy. Further prospective studies are needed to determine the optimal cut-off for CA125 levels in HF.
糖类抗原125（CA125）已成为心力衰竭（HF）患者的一种潜在生物标志物。本荟萃分析全面评估了HF人群中CA125水平与临床结局之间的关联。
我们基于系统评价和荟萃分析的首选报告项目（PRISMA）进行了本研究。我们系统检索了截至2025年4月的PubMed、Scopus、Web of Science和Embase数据库。我们选择了报告HF病例中CA125水平与临床结局之间关联的英文原始研究。采用随机效应模型和Hartung-Knapp-Sidik-Jonkman方法汇总效应量并报告汇总统计数据。本综述已在PROSPERO（CRD420251023141）注册。
共纳入29项研究中的20458例病例，平均年龄70.3岁，36.1%为女性。平均临界值水平为37.78 U/mL，主要采用35 U/mL作为CA125临界值水平。对9项报告终点事件（死亡或HF相关住院）风险的研究进行的荟萃分析显示，与CA125水平较低的患者相比，CA125水平较高的患者风险显著更高（HR 2.23，95%CI 1.69-2.93；p＜0.01；I=75.0%）。在急性心力衰竭（AHF）（基于两项研究的HR：1.88，95%CI 1.54-2.30；p＜0.01；I=39.6%）和慢性心力衰竭（CHF）（基于七项研究的HR：2.52，95%CI 1.69-3.77；p＜0.01；I=77.4%）亚组中，风险增加仍然显著。此外，对13项研究的相关性荟萃分析显示，CA125与B型利钠肽原水平之间存在显著的直接相关性（r=0.42；95%CI 0.30至0.54；p＜0.01；I=96.9%）。
本综述结果显示，CA125是HF人群死亡率和住院风险的重要预后因素。此外，CA125可能是一种用于评估疾病严重程度和监测治疗反应的非侵入性且不依赖操作者的工具。我们建议使用CA125来监测HF患者的各种治疗，特别是利尿剂治疗。需要进一步的前瞻性研究来确定HF中CA125水平的最佳临界值。
