The value of cancer antigen 125 ( Ca 125 ) and copeptin as markers in patients with advanced heart failure

Introduction. A search continues for new markers and new monitoring methods that would be useful in the management of patients with advanced heart failure (HF). Recent studies have shown increased levels of cancer antigen 125 (Ca 125) and copeptin in patients with HF which implies that they may be used as markers of HF. Material and methods. The aim of the study was to evaluate levels of potential HF markers in relation to established biochemical markers. The study included 60 patients who were admitted due to exacerbation of chronic New York Heart Association class III or IV systolic HF. Before administration of initial intravenous diuretic dose, blood samples were collected to determine levels of conventional prognostic factors (uric acid, B-type natriuretic peptide [BNP]) and novel HF biomarkers (Ca 125, copeptin). Results. On admission, BNP level (median 1166.50 pg/mL [636.00–2068.50]) and uric acid level (9.497 ± 2.426 mg/dL) in patients with HF was significantly higher compared to respective normal values. Ca 125 level (median 88.71 U/mL [29.28–169.00]) was also significantly increased, and copeptin level was significantly higher compared to the control group (median 96.55 vs 7.05 pg/mL, p < 0.0001). In additional, a statistically significant correlation between baseline BNP and Ca 125 levels (r = 0.48, p < 0.001) was observed. No correlations were found between baseline levels of copeptin and BNP or uric acid. Conclusion. In patients with chronic HF, several pathomechanisms are operating, which may be indicated by increased levels of several markers, including both conventional and new ones. Higher levels of Ca 125 were observed in patients with acute decompensated HF, even though these patients did not have a malignancy. However, Ca 125 did not exceed the prognostic value of BNP due to its low specificity. Despite different pathomechanisms of BNP and Ca 125 level elevations, a correlation was found between these markers, which might indicate a complex pathophysiology of HF in the studied group.