OBJECTIVES: This study sought to predict the value of tumor marker carbohydrate antigen 125 (CA125) before and after transcatheter aortic valve implantation (TAVI) for all-cause death and a composite endpoint of death, admission for heart failure, myocardial infarction, and stroke (major adverse cardiac events [MACE]). BACKGROUND: Risk stratification after TAVI remains challenging. The use of biomarkers in this setting represents an unmet need. METHODS: CA125 was measured in 228 patients before and after TAVI. The association with outcomes was assessed using parametric Cox regression and joint modeling for baseline and longitudinal analyses, respectively. CA125 was evaluated as logarithm transformation and dichotomized by its median value (M1 ≤15.7 U/ml vs. M2 >15.7 U/ml). RESULTS: At a median follow-up of 183 days (interquartile range: 63 to 365) and 144 days (interquartile range: 56 to 365), 50 patients (22%) died and 75 patients (33%) experienced MACE. A 3-fold increase in the rates for death and MACE was observed in patients above the median (M2 vs. M1) of CA125 (5.2 vs. 1.6 per 10 person-years and 8.3 vs. 3.3 per 10 person-years, respectively; p for both <0.001). In a multivariable analysis adjusted for logistic EuroSCORE, New York Heart Association functional class III/IV, and device success, baseline values of CA125 (M2 vs. M1) independently predicted death (hazard ratio [HR]: 2.18; 95% confidence interval [CI]: 1.11 to 4.26; p = 0.023) and MACE (HR: 1.77; 95% CI: 1.05 to 2.98; p = 0.031). In the longitudinal analysis, lnCA125 as a time-varying exposure, was highly associated with both endpoints: HR: 1.47; 95% CI: 1.01 to 2.14; p = 0.043 and HR: 2.26; 95% CI: 1.28 to 3.98; p = 0.005, for death and MACE, respectively. CONCLUSIONS: Serum levels of CA125 before and after TAVI independently predict death and MACE.
OBJECTIVES: This study sought to predict the value of tumor marker carbohydrate antigen 125 (CA125) before and after transcatheter aortic valve implantation (TAVI) for all-cause death and a composite endpoint of death, admission for heart failure, myocardial infarction, and stroke (major adverse cardiac events [MACE]). BACKGROUND: Risk stratification after TAVI remains challenging. The use of biomarkers in this setting represents an unmet need. METHODS:CA125 was measured in 228 patients before and after TAVI. The association with outcomes was assessed using parametric Cox regression and joint modeling for baseline and longitudinal analyses, respectively. CA125 was evaluated as logarithm transformation and dichotomized by its median value (M1 ≤15.7 U/ml vs. M2 >15.7 U/ml). RESULTS: At a median follow-up of 183 days (interquartile range: 63 to 365) and 144 days (interquartile range: 56 to 365), 50 patients (22%) died and 75 patients (33%) experienced MACE. A 3-fold increase in the rates for death and MACE was observed in patients above the median (M2 vs. M1) of CA125 (5.2 vs. 1.6 per 10 person-years and 8.3 vs. 3.3 per 10 person-years, respectively; p for both <0.001). In a multivariable analysis adjusted for logistic EuroSCORE, New York Heart Association functional class III/IV, and device success, baseline values of CA125 (M2 vs. M1) independently predicted death (hazard ratio [HR]: 2.18; 95% confidence interval [CI]: 1.11 to 4.26; p = 0.023) and MACE (HR: 1.77; 95% CI: 1.05 to 2.98; p = 0.031). In the longitudinal analysis, lnCA125 as a time-varying exposure, was highly associated with both endpoints: HR: 1.47; 95% CI: 1.01 to 2.14; p = 0.043 and HR: 2.26; 95% CI: 1.28 to 3.98; p = 0.005, for death and MACE, respectively. CONCLUSIONS: Serum levels of CA125 before and after TAVI independently predict death and MACE.
Authors: Neil Ruparelia; Vasileios F Panoulas; Angela Frame; Ben Ariff; Nilesh Sutaria; Michael Fertleman; Jonathan Cousins; Jon Anderson; Colin Bicknell; Andrew Chukwuemeka; Sayan Sen; Iqbal S Malik; Antonio Colombo; Ghada W Mikhail Journal: World J Cardiol Date: 2016-07-26
Authors: Hüseyin Ayhan; Hacı Ahmet Kasapkara; Tahir Durmaz; Telat Keleş; Cenk Sarı; Serdal Baştuğ; Kemal Eşref Erdoğan; Nihal Akar Bayram; Emine Bilen; Murat Akçay; Engin Bozkurt Journal: J Geriatr Cardiol Date: 2015-03 Impact factor: 3.327
Authors: Adam Csordas; Fabian Nietlispach; Philipp Schuetz; Andreas Huber; Beat Müller; Francesco Maisano; Maurizio Taramasso; Igal Moarof; Slayman Obeid; Barbara E Stähli; Martin Cahenzly; Ronald K Binder; Christoph Liebetrau; Helge Möllmann; Won-Keun Kim; Christian Hamm; Thomas F Lüscher Journal: PLoS One Date: 2015-12-02 Impact factor: 3.240
Authors: Matthias Lutz; Nora von Ingersleben; Moritz Lambers; Mark Rosenberg; Sandra Freitag-Wolf; Astrid Dempfle; Georg Lutter; Johanne Frank; Peter Bramlage; Norbert Frey; Derk Frank Journal: Open Heart Date: 2017-06-10