Simultaneous predictive value of NT-proBNP and CA-125 in patients newly diagnosed with advanced heart failure: preliminary results

Introduction: New markers of cardiac events and new monitoring methods which can improve care of patients with advanced heart failure (HF) are still being looked for. Material and methods: Sixty-five patients below 75 years old (mean age: 60.34 +/- 9.54 years), hospitalized with the first manifestation of HF (left ventricular ejection fraction <= 40%) and New York Heart Association (NYHA) class II-IV symptoms, not optimally treated before the study, were included. Blood samples for NT-proBNP and CA-125 were taken at baseline and during the 12-month follow-up period. The doses of beta-adrenolytics and angiotensin-converting enzyme (ACE) inhibitors were titrated to maximal tolerated ones according to the guidelines in 1-year follow-up. The endpoint was established as overall death and time to death. Results: Worse prognosis was observed in groups with: 1) NT-proBNP and CA-125 above medians (OR = 492.9, p = 0.006), 2) baseline higher NT-proBNP and CA-125 (HR = 0.016, p < 0.001), 3) increased or stable marker levels during the first 3 months after treatment implementation. Conclusions: Elevated values of NT-proBNP and CA-125 are found as the independent death risk factors. The group with initial elevated NT-proBNP and CA-125 concentrations had a worse prognosis. Changes in NT-proBNP and CA-125 levels after treatment implementation predict unfavourable cardiovascular events with better CA-125 than NT-proBNP performance.