Insights into the clinical implications of carbohydrate antigen 125 as a biomarker of heart failure: a meta-analysis and systematic review of published studies

AimsAn increasing number of clinical studies have explored the possibility of using tumor biomarker carbohydrate antigen 125 (CA 125) in the management of patients with heart failure. This systematic review and meta-analysis was performed to comprehensively summarize the available evidence and evaluate the applicability of CA 125 in heart failure.MethodsWe searched PubMed, Embase, and Cochrane Central Register of controlled trials. Of the 253 studies identified, 23 studies investigating the application of CA 125 in the clinical management of heart failure were included for meta-analyses and systematic review.ResultsThe serum levels of CA 125 increased significantly in heart failure patients compared with healthy controls (standardized mean difference of 1.49U/ml, P<0.001). The fluctuation of CA 125 was closely associated with echocardiographic parameters. Likewise, the CA 125 levels were positively correlated with brain natriuretic peptide and N-terminal pro-BNP. Further investigation found that CA 125 levels increased accordingly as cardiac function declined from the New York Heart Association class I/II to class III and further from class III to IV [1.58, 95% confidence interval (0.75-2.41) and 1.37, 95% confidence interval (0.76-1.98)U/ml, respectively]. Heart failure patients with poor outcomes showed higher CA 125 level relative to those without adverse effects in short-term or long-term follow-up.ConclusionCA 125 is a promising biomarker in the diagnosis, stratification, and outcome evaluation of heart failure patients. CA 125 may be regarded as a surrogate marker of echocardiographic variables, N-terminal pro-BNP and brain natriuretic peptide.