Serum CA125: a prognostic biomarker for mortality in chronic heart failure

Abstract

Objective

To examine the relationship between serum Carbohydrate Antigen 125 (CA125) levels and long-term mortality in Chronic Heart Failure (CHF) patients and to assess its predictive value as a biomarker.

Methods

This was a retrospective cohort study. We reviewed the medical records of 4,442 consecutive patients admitted to the First Affiliated Hospital of Xinjiang Medical University with a diagnosis of CHF since July 2012. After applying inclusion and exclusion criteria, 1,413 patients with available CA125 level measurements were included. The patients were categorized into three groups based on ejection fraction: HFrEF, HFmrEF, and HFpEF. Demographic details, comorbidities, and laboratory parameters were collected. CA125 levels were measured using an automated chemiluminescent immunoassay. Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards regression.

Results

The median follow-up was 22.75 months. Elevated CA125 levels were significantly associated with increased all-cause mortality (ACM) across all CHF subtypes (HR = 2.05, 95% CI: 1.60–2.64, P < 0.001), especially in the HFpEF group (HR = 2.32, 95% CI: 1.59–3.40, P < 0.001). The area under the ROC curve for CA125 was 0.655, indicating moderate predictive accuracy. Multivariate analysis revealed that patients with CA125 levels ≥ 20.8 U/mL had a significantly higher risk of ACM (HR = 2.05). Adjustments for confounding factors did not alter these findings.

Conclusion

Our findings suggest that serum CA125 levels may serve as a potential prognostic biomarker for mortality in CHF patients, particularly in the HFpEF subgroup. However, further research is needed to confirm these findings and elucidate the underlying mechanisms.