Heart failure & cardiomyopathiesCase-control study
High CA125 levels as a red flag for ATTR cardiac amyloidosis
- retrospective, multicentre, case-control study
- consecutive ambulatory patients
- three tertiary centres
Authors' conclusion
In ambulatory patients with suspected ATTR-CA, a CA125 > 40 U/mL, particularly when combined with elevated NT-proBNP, supports the clinical suspicion of the disease. High CA125 levels may be useful in ATTR-CA recognition.
Study context
- Population
- Ambulatory patients who underwent 99mTc-DPD scintigraphy for suspected cardiac amyloidosis and had a CA125 determination available at the time of the evaluationconsecutive ambulatory patients (median age 79 years, 74.8% male)
- Participants
- 626 patients
- Comparison
- CA125 as a 'rule-in' biomarker for suspected ATTR-CA
- ATTR-CAn = 451
- ruled outn = 175
Main finding
As reported in the abstract
CA125 levels
P = 0.065
Observational data: associations, not effects.
Further findings
CA125 as predictor for the diagnosis of ATTR-CA
| Comparison | odds ratio (95% CI) | P value | |
|---|---|---|---|
| CA125 | 2.109 (1.197–3.717) | P = 0.01 | |
| 0.20.5125Odds ratio (log scale) |
Combining CA125 (>40 U/mL) and NT-proBNP (>2500 pg/mL)
| Comparison | odds ratio (CI) | P value | |
|---|---|---|---|
| both biomarkers above their respective cut-offs · three-fold higher likelihood of ATTR-CA | 3.38 (1.704–6.719) | P < 0.001 | |
| 0.10.31310Odds ratio (log scale) |
- CA125 as predictor for the diagnosis of ATTR-CA: multivariate logistic regression model; independent predictor
Positive predictive value of CA125 cut-off of 40 U/mL
- positive predictive value
- 81.7% (95% confidence interval: 78.6%-84.7%)
Combining CA125 (>40 U/mL) and NT-proBNP (>2500 pg/mL)
- significantly improved the diagnostic accuracy of the model
Original publication
High CA125 levels as a red flag for ATTR cardiac amyloidosis. ESC Heart Fail. Published 22 July 2026. doi:10.1093/eschf/xvag199
Summarised from the published abstract; every number is checked against it