Heart failure & cardiomyopathiesSecondary analysis
Carbohydrate Antigen 125 Concentrations Across the Ejection Fraction Spectrum in Chronic Heart Failure: The EMPEROR Programme
- Secondary analysis of the EMPEROR-Reduced and EMPEROR-Preserved randomised trials
Authors' conclusion
Across the range of EF in patients with chronic HF enrolled in the EMPEROR trials, the majority of whom did not have clinical evidence of congestion, CA-125 concentrations were not significantly associated with congestive signs or symptoms. CA-125 concentrations may predict HF hospitalization/CV death in patients with HFrEF, but not those with HFpEF.
Study context
- Population
- Patients with chronic heart failure (HF) across the ejection fraction (EF) spectrum in the EMPEROR trials
- Participants
- 1,111 patients
- Comparison
- CA-125 tertile 3 vs tertile 1
- Primary endpoint
- First HF hospitalization or CV death
Primary result
As reported in the abstract
Hazard ratio
1.34
95% CI 0.91–1.96
P = 0.11 for trend
Tertile 3 vs Tertile 1
HR 1.34 (95% CI 0.91–1.96); P for trend = 0.11
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| First HF hospitalization or CV death, by EF (subgroup) — Tertile 3 vs Tertile 1 · HFrEF | 2.25 (1.30–3.89) | |
| First HF hospitalization or CV death, by EF (subgroup) — Tertile 3 vs Tertile 1 · HFpEF | 0.68 (0.38–1.21) | |
| 0.20.5125Hazard ratio (log scale) |
- First HF hospitalization or cardiovascular (CV) death, by EF (subgroup): interaction-p = 0.02
Congestive signs or symptoms
- No significant association between baseline CA-125 and congestive signs or symptoms
eGFR decline over time
- Steepest eGFR decline in upper CA-125 tertile
- P for trend = 0.03
Empagliflozin effect on CV death or HF hospitalization, by baseline CA-125
- Effect appeared attenuated with lower baseline CA-125
- interaction-p-trend = 0.09
Original publication
Carbohydrate Antigen 125 Concentrations Across the Ejection Fraction Spectrum in Chronic Heart Failure: The EMPEROR Programme. Eur J Heart Fail. Published 4 March 2024. doi:10.1002/ejhf.3166
Summarised from the published abstract; every number is checked against it