Docherty, K. F. et al. (2023) Association of carbohydrate antigen 125 on the response to dapagliflozin in patients with heart failure. Journal of the American College of Cardiology, 82(2), pp. 142-157. (doi: 10.1016/j.jacc.2023.05.011) (PMID:37407113)
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Abstract
Background: Elevated circulating carbohydrate antigen 125 (CA125) is a marker of congestion and a predictor of outcomes in acute heart failure (HF). Less is known about CA125 in chronic ambulatory HF with reduced ejection fraction. Objectives: This study examined the association between baseline CA125 (and changes in CA125) and outcomes in patients with HF with reduced ejection fraction in the DAPA-HF (Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure; NCT03036124) trial and its relationship with the effect of dapagliflozin. Methods: The primary outcome was a composite of a first episode of worsening HF or cardiovascular death. CA125 was measured at baseline and 12 months following randomization. Results: Median baseline CA125 was 13.04 U/mL (IQR: 8.78-21.13 U/mL) in 3,123 of 4,774 patients with available data. Compared with CA125 ≤35 U/mL (upper limit of normal), patients with CA125 >35 U/mL were at a higher risk of the primary outcome (adjusted HR: 1.59; 95% CI: 1.29-1.96). The adjusted risks of the primary outcome relative to quartile 1 (Q1) (≤8.78 U/mL) were as follow: Q2, 8.79-13.04 U/mL (HR: 0.94; 95% CI: 0.71-1.24); Q3, 13.05-21.13 U/mL (HR: 1.22; 95% CI: 0.94-1.59); Q4, ≥21.14 U/mL (HR: 1.63; 95% CI: 1.28-2.09). The beneficial effect of dapagliflozin compared with placebo on the primary outcome was consistent whether CA125 was analyzed in quartiles (interaction P = 0.13) or as a continuous variable (interaction P = 0.75). The placebo-corrected relative change in CA125 at 12 months was −5.2% (95% CI: −10.6% to 0.5%; P = 0.07). Conclusions: In DAPA-HF, elevated CA125 levels were an independent predictor of the risk of worsening HF or cardiovascular death. Dapagliflozin reduced the risk of worsening HF or cardiovascular death regardless of baseline CA125.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | McDowell, Dr Kirsty and Docherty, Dr Kieran and Jhund, Professor Pardeep and Welsh, Professor Paul and Kober, Professor Lars and Osmanska, Dr Joanna and Sattar, Professor Naveed and McMurray, Professor John |
| Authors: | Docherty, K. F., McDowell, K., Welsh, P., Osmanska, J., Anand, I., de Boer, R. A., Køber, L., Kosiborod, M. N., Martinez, F. A., O’Meara, E., Ponikowski, P., Schou, M., Berg, D. D., Sabatine, M. S., Morrow, D. A., Jarolim, P., Hammarstedt, A., Sjöstrand, M., Langkilde, A. M., Solomon, S. D., Sattar, N., Jhund, P. S., and McMurray, J. J.V. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
| Journal Name: | Journal of the American College of Cardiology |
| Publisher: | Elsevier |
| ISSN: | 0735-1097 |
| ISSN (Online): | 1558-3597 |
| Published Online: | 03 July 2023 |
| Copyright Holders: | Copyright © 2023 The Authors |
| First Published: | First published in Journal of the American College of Cardiology 82(2): 142-157 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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