The Potential Role of CA-125 as a Biomarker for Short-Term Mortality Risk in Patients with Acute Symptomatic Pulmonary Embolism
Crhistian-Mario Oblitas 1) 2) 3), Francisco Galeano-Valle 1) 2) 3), Marta-Olimpia Lago-Rodríguez 1) 2) 3), Marina López-Rubio 1) 2) 3), Jesús Baltasar-Corral 1), Mercedes García-Gámiz 4), Angielys Zamora-Trillo 4), Luis-Antonio Alvarez-Sala Walther 1) 2) 3), Pablo Demelo-Rodríguez 1) 2) 3)
1-Venous Thromboembolism Unit, Internal Medicine Department, General University Hospital Gregorio Marañón, 28007 Madrid, Spain
2-School of Medicine, University Complutense of Madrid, 28007 Madrid, Spain
3-Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
4-Department of Clinical Biochemistry, General University Hospital Gregorio Marañón, 28007 Madrid, Spain
Abstract
Background
Antigen carbohydrate 125 (CA-125) is a complex glycoprotein extensively studied as a prognostic biomarker in heart failure, yet its potential role in the short-term prognosis of an acute pulmonary embolism (PE) remains unexplored.
Methods
In this observational, prospective, single-center study, consecutive patients aged 18 and older with a confirmed acute symptomatic PE and no history of prior anticoagulant therapy were enrolled.
Primary and secondary objectives
aimed to assess the prognostic capacity of CA-125 at PE diagnosis for 30-day mortality and major bleeding, respectively.
Results
A total of 164 patients were included (mean age 69.8 years, SD 17), with 56.1% being male. Within 30 days, 17 patients (10.4%) died and 9 patients (5.5%) suffered major bleeding. ROC curve analysis for 30-day mortality yielded an area under the curve of 0.69 (95% CI 0.53–0.85) with an optimal CA-125 cut-off point of 20 U/mL and a negative predictive value of 96%. Multivariate analysis revealed a significant association between CA-125 levels exceeding 20 U/mL and 30-day mortality (adjusted odds ratio 4.95; 95% CI 1.61–15.2) after adjusting for age, cancer, NT-proBNP > 600 ng/mL, and the simplified pulmonary embolism severity index score. Survival analysis for 30-day mortality exhibited a hazard ratio of 5.47 (95% CI 1.78–16.8). No association between CA-125 levels and 30-day major bleeding was found.
Conclusions
CA-125 emerges as a promising surrogate biomarker for short-term mortality prediction in an acute symptomatic PE. Future investigations should explore the integration of CA-125 into PE mortality prediction scores to enhance the prognostic accuracy in this patient population.