Usefulness of Antigen Carbohydrate 125 and N-Terminal Pro-B-Type Natriuretic Peptide for Assessing Congestion in Chronic Heart Failure: Insights from the CARDIOREN Registry
Por:
Ordás, JG, Nuñez, J, Claret, RB, Llacer, P, Zegri-Reiriz, I, de la Espriella, R, Fort, A, Rubio-Gracia, J, Blazquez-Bermejo, Z, Mendez, A, Ponz, I, Chaverri, AR, Caravaca-Pérez, P, Mayoral, A, Rubio, CJ, Pomares, A, Soler, MJ, Fluviá, P, Magallón, BG, Górriz, JL, Manzano, L, Husain-Syed, F, Marcos, MC
Publicada:
1 ene 2024
Resumen:
Introduction:A comprehensive assessment of congestion,including circulating biomarkers, is recommended in patientswith acute heart failure. The circulating biomarkers natriureticpeptides (NPs) and carbohydrate antigen-125 (CA125) could be useful for congestion assessment in ambulatory chronicheart failure (CHF), but there is only limited information abouttheir applicability in this context. Therefore, this study aimed toexamine the association of plasma CA125 and NP levels withclinical and ultrasound congestion parameters in CHF.Methods:This is a cross-sectional substudy of the CardiorenSpanish Registry, which enrolled 1,107 patients with CHF from13 tertiary hospitals in Spain between October 2021 andFebruary 2022. Through ambulatory visits, we performed acomprehensive assessment of congestion-related parameters,including clinical variables (orthopnea, peripheral edema, andjugular engorgement, represented by the composite con-gestion score [CCS]),echocardiography variables (lung B-linesand inferior vena cava [IVC] diameter), and circulating bio-markers (CA125 and NPs). The association of the NP and CA125levels with the clinical and echocardiographic congestionparameters was examined by multiple linear and logistic re-gression analyses.Results:This substudy included 802 patientsfor whom all the biomarker parameters were available {medianage, 74 (interquartile range [IQR], 63-81) years; 65% male}. Theproportion of patients with left ventricular ejection frac-tion >= 50% and estimated glomerularfiltration rate<60 was34% and 58%, respectively. The median CCS was 0 (IQR: 0-1),with 45% of the sample exhibiting a median CCS of >= 1. Thejugular engorgement, peripheral edema, and orthopnea rateswere 32%, 21%, and 21%, respectively. A total of 35% ofpatients who underwent ultrasound examination showed lungB-lines, and the median IVC diameter was 16 mm. The medianCA125 and NTproBNP levels were 14 U/mL (IQR: 9-28) and1,382 pg/mL (IQR: 563-3,219), respectively. Multivariate anal-ysis showed that higher CA125levels were independentlyassociated with higher odds of peripheral edema (p= 0.023)and lung B-lines (p<0.001). Further, NTproBNP was positivelyassociated with jugular engorgement (p<0.001), orthopnea(p= 0.034), and enlarged IVC diameter (p= 0.031).Conclusions:Clinical signs of congestion are frequent in CHF. In the am-bulatory setting, NTproBNP was associated with parameterslinked to intravascular congestion such as orthopnea, jugularengorgement, and IVC diameter, whereas CA125 was associ-ated with extravascular volume overload parameters (pe-ripheral edema and lung B-lines).(c) 2024 The Author(s).Published by S. Karger AG, Basel
Filiaciones:
Ordás, JG:
Univ Lleida, Hosp Arnau Vilanova, Lleida, Spain
Inst Recerca Biomed IRB, Lleida, Spain
Nuñez, J:
Hosp Clin Univ Valencia, Dept Cardiol, Valencia, Spain
Univ Valencia, Fac Med, Valencia, Spain
Ctr Invest Biomed Red CIBER Cardiovasc, Madrid, Spain
Claret, RB:
Univ Lleida, Hosp Arnau Vilanova, Lleida, Spain
Inst Recerca Biomed IRB, Lleida, Spain
Llacer, P:
Hosp Univ Ramon & Cajal, Dept Internal Med, Madrid, Spain
Zegri-Reiriz, I:
Hosp Santa Creu & Sant Pau, Cardiol Dept, Heart Failure & Heart Transplant Unit, Barcelona 08025, Spain
de la Espriella, R:
Hosp Clin Univ Valencia, Dept Cardiol, Valencia, Spain
Fort, A:
Univ Girona IDIBGI, Hosp Univ Dr Josep Trueta, Girona, Spain
Rubio-Gracia, J:
Univ Hosp Lozano Blesa, Dept Internal Med, Zaragoza, Spain
Blazquez-Bermejo, Z:
Hosp Gen Univ Gregorio Maranon, Dept Cardiol, Madrid, Spain
Mendez, A:
Hosp Univ Vall dHebron, Dept Cardiol, Barcelona, Spain
Ponz, I:
Hosp Univ La Paz, Dept Cardiol, Madrid, Spain
Chaverri, AR:
Hosp Univ La Paz, Dept Cardiol, Madrid, Spain
Caravaca-Pérez, P:
Hosp Clin Barcelona, Dept Cardiol, Barcelona, Spain
Mayoral, A:
Hosp Univ Virgen Macarena, Dept Cardiol, Seville, Spain
Rubio, CJ:
Hosp Univ Virgen Victoria, Dept Cardiol, Malaga, Spain
IBIMA Plataforma BIONAND, Malaga, Spain
Pomares, A:
Hosp Santa Creu & Sant Pau, Cardiol Dept, Heart Failure & Heart Transplant Unit, Barcelona 08025, Spain
Soler, MJ:
Hosp Univ Virgen Macarena, Dept Cardiol, Seville, Spain
Fluviá, P:
Univ Girona IDIBGI, Hosp Univ Dr Josep Trueta, Girona, Spain
Magallón, BG:
Hosp Univ Puerta Hierro, Dept Cardiol, Majadahonda, Spain
Górriz, JL:
Hosp Clin Univ Valencia, Dept Nephrol, Valencia, Spain
Manzano, L:
Hosp Univ Ramon & Cajal, Dept Internal Med, Madrid, Spain
Husain-Syed, F:
Justus Liebig Univ Giessen, Univ Hosp Giessen & Marburg, Dept Internal Med 2, Giessen, Germany
San Bortolo Hosp, Int Renal Res Inst Vicenza, Dept Nephrol Dialysis & Transplantat, Vicenza, Italy
Marcos, MC:
Ctr Invest Biomed Red CIBER Cardiovasc, Madrid, Spain
Hosp Univ Puerta Hierro, Dept Cardiol, Majadahonda, Spain
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