Prognostic value of carbohydrate antigen 125 combined with N-terminal pro B-type natriuretic peptide in patients with acute heart failure: a prospective cohort study in Vietnam

Abstract

Background: Carbohydrate antigen 125 (CA125) is an emerging prognostic biomarker for acute heart failure (AHF). This study aimed to evaluate the prognostic utility of CA125 in combination with N-terminal pro–B-type natriuretic peptide (NT-proBNP) for predicting cardiovascular mortality, all-cause mortality, and a composite outcome of all-cause mortality or rehospitalization due to heart failure in patients with AHF. Methods: This prospective observational study included 316 patients with AHF. Both CA125 and NT-proBNP levels were measured at the time of first admission. Mortality and rehospitalization due to heart failure were recorded over a 12-month follow-up period. Results: During the follow-up period, 38 patients (12.0%) died from cardiovascular disease, 81 patients (25.6%) died from any cause, and 145 patients (45.9%) experienced either all-cause mortality or rehospitalization due to heart failure. In multivariate Cox regression analyses, the combination of high CA125 and high NT-proBNP levels was associated with increased risks of cardiovascular mortality (adjusted Hazard Ratio [aHR] = 11.77, 95% Confidence Interval [CI]: 3.73–37.09, p < 0.001), all-cause mortality (aHR = 4.53, 95% CI: 1.99–10.28, p < 0.001), and the composite outcome (aHR = 6.02, 95% CI: 2.75–13.24, p < 0.001). The addition of CA125 significantly improved prognostic performance when combined with NT-proBNP. Conclusions: Both CA125 and NT-proBNP are significant prognostic biomarkers in patients with AHF. The combination of CA125 and NT-proBNP significantly enhances the prediction of cardiovascular mortality, all-cause mortality and the composite outcome of all-cause mortality or rehospitalization due to heart failure in patients with AHF.