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Vol. 58. Issue 3.
Pages 172-179 (July - September 2023)
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Vol. 58. Issue 3.
Pages 172-179 (July - September 2023)
Artículo original
Papel de los niveles circulantes del antígeno carbohidrato 125 para identificar al paciente no frágil con IC
Role of plasma carbohydrate antigen 125 to identify nonfrail patients in HF
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Clara Sastrea, Ana Martínezb, Adora Péreza, Anna Mollara,c, José M. Civeraa, Adriana Conesaa, Amparo Villaescusaa, Juan Sanchisa,c, Patricia Palaua, Gema Miñanaa,c, Rafael de la Espriellaa, Julio Núñeza,c,
Corresponding author
yulnunez@gmail.com

Autor para correspondencia.
a Departamento de Cardiología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Instituto de Investigación Sanitaria (INCLIVA), Valencia, España
b Departamento de Epidemiología, Centro Valenciano de Salud Pública, Valencia, España
c Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), España
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Germán Cediel, Antoni Bayés-Genís
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Tables (2)
Tabla 1. Descripción de los componentes del fenotipo de fragilidad propuesto por Fried
Tabla 2. Características basales
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Resumen
Introducción y objetivos

La insuficiencia cardiaca (IC) se relaciona con alta prevalencia de fragilidad. Sin embargo, su evaluación no es rutinaria en la práctica clínica. Por ello, es necesario encontrar herramientas que la evalúen. Los niveles plasmáticos elevados del antígeno carbohidrato 125 (CA-125) se relacionan con mayor riesgo de episodios adversos clínicos en estos pacientes. Este trabajo evaluó la posible relación entre los valores de CA-125 y las categorías de fragilidad en pacientes con IC.

Métodos

En este estudio observacional, unicéntrico y prospectivo, junto con las características basales del paciente estable con IC, se evaluó la fragilidad mediante la escala Fried. La capacidad discriminativa del CA-125 para el diagnóstico se evaluó mediante la curva receiver operating characteristic (ROC).

Resultados

En 277 pacientes (74±10 años, 42,59% mujeres, 52,70% fracción de eyección del ventrículo izquierdo<50% y 81,22% grado I-II de la New York Heart Association). Se registraron 61 (22,02%) robustos (Fried=0), 95 (34,29%) prefrágiles (Fried=1-2) y 121 (46,68%) frágiles (Fried ≥ 3). Los valores CA-125 fueron inferiores en robustos (13 U/ml [9-23] frente a 19 U/ml (12-41), p=0,002) y valores ≤ 10 U/ml mostraron un valor predictivo negativo del 66% para descartar al prefrágil/frágil. Hubo asociación significativa, positiva no lineal entre CA-125 y la escala Fried (p=0,003). Valores de CA-125 ≤ 10 U/ml mostraron una elevada probabilidad de presencia de robustez.

Conclusiones

Con IC crónica, el CA-125 ≤ 10 U/ml predijo la presencia de robustez.

Palabras clave:
Insuficiencia cardiaca ambulatoria
Biomarcador
CA-125
Fragilidad
Abreviaturas:
CA125
IGF-1
IC
TNF-α
Abstract
Introduction and objectives

Heart failure (HF) is an age-related syndrome with a high burden of frailty. However, frailty assessment is not regularly performed in clinical practice. Therefore, a clinical tool for frailty assessment is still required. High levels of Plasma carbohydrate antigen 125 (CA125) are related with a higher risk of adverse clinical events. In this study we aimed to evaluate different CA125 values and its association with frailty categories in HF.

Methods

In this observational, single-center and prospective study, frailty was assessed by Fried score along with the baseline characteristics of the HF stable patient. The discriminative ability of CA125 for predicting frailty status was evaluated by receiver operating characteristic (ROC).

Results

In 277 patients (74±10 years, 42.59% women, 52.70% left ventricular ejection fraction <50% and 81.22% New York Heart Association grade I-II). There were 61 (22.02%) robust (Fried=0), 95 (34.29%) pre-frail (Fried=1-2) and 121 (46.68%) frail (Fried ≥ 3). CA125 values were lower in robust (13 U/mL (9-23) vs 19 U/mL (12-41), P=.002) and values ≤ 10 U/mL showed a negative predictive value of 66% to rule out the pre-frail/frailty status. Significant, positive, and non-linear association between CA125 and the Fried score (P=.003) was found. CA125 values ≤ 10 U/mL showed a high probability of the presence of robustness.

Conclusions

In a cohort of patients with chronic HF, low values of CA125 (< 10 U/mL) predicted robust patients.

Keywords:
Ambulatory heart failure
Biomarker
CA125
Frailty

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