Akademik Veri Yönetim Sistemi
HEART & LUNG, cilt.74, ss.90-95, 2025 (SCI-Expanded, Scopus)
Background: Elevated circulating cancer antigen-125 (Ca-125) in heart failure has been proposed as a congestive and prognostic biomarker for patients with acute decompensated heart failure (ADHF). However, the relationship between circulating Ca-125 and diuretic efficiency in this population remains unknown. Objectives: We hypothesized that hospitalized ADHF patients with increased circulating Ca-125 levels are prone to high risk for the development of insufficient diuretic response. Methods: We conducted the Receiver operator characteristics (ROC) analysis and binary logistic regression analysis to reveal the association between circulating Ca-125 level and diuretic response in hospitalized patients with ADHF. Insufficient diuretic response was defined as (1) a spot urinary Na+ <50 mEq/L in the spot urine sample collected 2 h following loop diuretic administration, and (2) <100 mL/hour diuresis after loop diuretic administration. Results: In the prospective observational cohort study, we enrolled 168 hospitalized patients with ADHF. Insufficient diuretic response and worsening renal function occurred in 45 (26.8 %) and 83 (49.4 %) patients, respectively. ROC analysis revealed that the optimal cut off of Ca-125 was 97.6 U/mL with a sensitivity of 64 %, and a specificity of 78 %. Overall model quality was 0.60. Using the binary logistic regression model, Ca-125 >= 97.6 U/mL (OR: 6.238, 95 %CI:2.712-14.349) and creatinine (OR: 4.194, 95 %CI:1.162-15.131) were independent predictors for the development of insufficient diuretic response. Conclusion: In hospitalized patients with ADHF, Ca-125 >= 97.6 U/mL can be an effective sign in forecasting diuretic efficiency and may contribute to a better risk stratification for the development of insufficient diuretic response.