Effects of empagliflozin on CA125 trajectory in patients with chronic congestive heart failure

Introduction: We aimed to evaluate the trajectory of two surrogates of fluid overload -antigen carbohydrate 125 (CA125) and amino-terminal pro-brain natriuretic peptide (NT-proBNP)- after the addition of oral empagliflozin to usual care in a cohort of patients with chronic heart failure (CHF) and type 2 diabetes (T2D). Methods and results: From October 2015 to February 2019, 60 ambulatory patients with CHF and T2D were ret-rospectively included. The primary endpoint was to assess the longitudinal trajectory of plasma levels of CA125 and NT-proBNP after empagliflozin initiation. Changes in quantitative variables were evaluated using lin -ear mixed regression. Median CA125 and NT-proBNP at baseline were 17 (11-75) U/mL and 1662 (647-4230) pg/mL, respectively. A total of 510 outpatient visits were recorded [median (interquartile range) of visits per pa-tient: 6 (4-11)] during a median of 1.78 years. We found a significant and steady decrease in the log of CA125 after empagliflozin initiation (p < 0.001). Conversely, the log of NT-proBNP predicted trajectory did not signifi-cantly change (p = 0.425). Conclusion: In this cohort of patients with CHF and T2D, empagliflozin initiation was associated with a significant decrease in CA125 levels without modifying the trajectory of NT-proBNP. Considering that CA125 has emerged as a surrogate marker of tissue congestion, we hypothesize that empagliflozin might predominantly promote extra-vascular decongestion. (c) 2021 Elsevier B.V. All rights reserved.

Automated summary

This study aimed to evaluate the trajectory of CA125 and NT-proBNP in patients with chronic heart failure and type 2 diabetes after initiating oral empagliflozin. The results showed a significant decrease in CA125 levels and no significant change in NT-proBNP levels following empagliflozin initiation.