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:
Gayán Ordás J, Nuñez J, Bascompte Claret R, Llacer P, Zegri-Reiriz I, De la Espriella R, Fort A, Rubio-Gracia J, Blazquez-Bermejo Z, Mendez A, Ponz I, Rodriguez Chaverri A, Caravaca-Pérez P, Recio Mayoral A, Jiménez Rubio C, Pomares A, José Soler M, Fluviá P, García Magallón B, Luis Górriz J, Manzano L, Husain-Syed F, Cobo Marcos M
Publicada:
1 ene 2024
Ahead of Print:
5 sep 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:
Gayán Ordás J:
Lleida and Pyrenees Heart Failure Unit, Hospital Arnau de Vilanova, Lleida, Spain
Institut de Recerca Biomedica (IRB), Lleida, Spain
Nuñez J:
Department of Cardiology, Hospital Clínico Universitario de Valencia, Valencia, Spain
Medicine Department, Universitat de Valencia (Spain), Valencia, Spain
Centro de Investigacion Biomedica en Red (CIBER Cardiovascular), Madrid, Spain
Bascompte Claret R:
Lleida and Pyrenees Heart Failure Unit, Hospital Arnau de Vilanova, Lleida, Spain
Institut de Recerca Biomedica (IRB), Lleida, Spain
Llacer P:
Department of Internal Medicine, Hospital Universitario Ramon y Cajal, Madrid, Spain
Zegri-Reiriz I:
Heart Failure and Transplant Unit, Department of Cardiology, Hospital of Santa Creu and Sant Pau, Barcelona, Spain
De la Espriella R:
Department of Cardiology, Hospital Clínico Universitario de Valencia, Valencia, Spain
Fort A:
Department of Cardiology, Hospital Universitario Josep Trueta, Girona, Spain
Rubio-Gracia J:
Department of Internal Medicine, Hospital Universitario Lozano Blesa, Zaragoza, Spain
Blazquez-Bermejo Z:
Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Mendez A:
Department of Cardiology, Hospital Universitario Vall d'Hebron, Barcelona, Spain
Ponz I:
Department of Cardiology, Hospital Universitario La Paz, Madrid, Spain
Rodriguez Chaverri A:
Department of Cardiology, Hospital Universitario La Paz, Madrid, Spain
Caravaca-Pérez P:
Department of Cardiology, Hospital Clinic, Barcelona, Spain
Recio Mayoral A:
Department of Cardiology, Hospital Universitario Virgen Macarena, Sevilla, Spain
Jiménez Rubio C:
Department of Cardiology, Hospital Universitario Virgen de la Victoria, Malaga, Spain
IBIMA-Plataforma BIONAND, Málaga, Spain
Pomares A:
Heart Failure and Transplant Unit, Department of Cardiology, Hospital of Santa Creu and Sant Pau, Barcelona, Spain
José Soler M:
Department of Cardiology, Hospital Universitario Vall d'Hebron, Barcelona, Spain
Fluviá P:
Department of Cardiology, Hospital Universitario Josep Trueta, Girona, Spain
García Magallón B:
Department of Cardiology. Hospital Universitario Puerta de HIerro, Majadahonda, Spain
Luis Górriz J:
Department of Nephrology, Hospital Clínico Universitario de Valencia, Valencia, Spain
Manzano L:
Department of Internal Medicine, Hospital Universitario Ramon y Cajal, Madrid, Spain
Husain-Syed F:
Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus-Liebig-University Giessen, Giessen, Germany
International Renal Research Institute of Vicenza, Department of Nephrology, Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy
Cobo Marcos M:
Centro de Investigacion Biomedica en Red (CIBER Cardiovascular), Madrid, Spain
Department of Cardiology. Hospital Universitario Puerta de HIerro, Majadahonda, Spain
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