Heart failure & cardiomyopathies
Evaluation of carbohydrate antigen 125 in heart failure with preserved ejection fraction diagnosis
Authors' conclusion
In an ambulatory setting, CA125 exhibits acceptable diagnostic performance for identifying HFpEF and may complement NT-proBNP in clinical practice.
Study context
- Population
- Outpatients with clinically suspected heart failure (HF)final study cohort, 246 consecutive patients enrolled, LVEF <50% (n=8) and history of malignancy (n=22) excluded
- Participants
- 210 outpatients
- Exposure
- Diagnostic performance of CA125 in identifying HF with preserved ejection fraction (HFpEF), compared with NT-proBNP; diagnosis confirmed by a trained cardiologist
- Outcome
- AUC for HFpEF diagnosis
Methodological detailsconsecutive patients, cardiologist blinded to the biomarker levels
- Consecutive patients
- Cardiologist blinded to the biomarker levels
Main finding
As reported in the abstract
NT-proBNP
0.765
AUC · 95% CI 0.686–0.843
CA125
0.715
AUC · 95% CI 0.636–0.793
P = 0.323
Observational data: associations, not effects.
Further findings
| Outcome | CA125 | NT-proBNP |
|---|---|---|
| Optimal cut points for HFpEF diagnosis | cut point 12.2 U/mL | cut point 243 pg/mL |
| Sensitivity | 0.69 | 0.65 |
| Specificity | 0.68 | 0.83 |
- Elevated CA125 (>23 U/mL) for HFpEF
- 12.4% · share of sample with CA125 >23 U/mL · specificity 0.97 · positive predictive value 80.8% · correctly classified 77.1%
- CA125 <9 U/mL for HFpEF
- 85.7% · negative predictive value
Cohort characteristics
- Mean age
- 69.7±15 years
- Women
- 69%
- Median NT-proBNP
- 125 pg/mL (IQR: 51-332)
- Median CA125
- 11 U/mL (IQR: 8-17)
- HFpEF diagnosed
- 65 (31%)
Original publication
Evaluation of carbohydrate antigen 125 in heart failure with preserved ejection fraction diagnosis. Heart. Published 28 August 2025. doi:10.
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