Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(10), 1129–1136. https://doi.org/10.1002/clc.24064 Dr. Carlos Diaz-Arocutipa et al.
Points
- Transcatheter aortic valve replacement (TAVR) is a commonly used therapy for severe aortic stenosis.
- A systematic review examined the prognostic role of carbohydrate antigen 125 (CA-125) in TAVR patients.
- Higher levels of CA-125 were significantly associated with increased mortality or heart failure readmission at 12 months.
- The meta-analysis demonstrated a strong association between elevated CA-125 levels and higher mortality rates.
- Further research is needed to determine the clinical utility of CA-125 in guiding treatment decisions for TAVR patients.
Summary
Transcatheter aortic valve replacement (TAVR) has emerged as a widely utilized therapy for patients suffering from severe aortic stenosis. In recent years, there has been growing interest in the potential prognostic role of carbohydrate antigen 125 (CA-125) in various cardiovascular diseases. This systematic review evaluates the association between preprocedural CA-125 levels and mortality or heart failure (HF) readmission at 12 months in patients undergoing TAVR. By synthesizing data from cohort studies, this review seeks to provide insights into the prognostic value of CA-125 in this specific patient population.
A comprehensive search of electronic databases encompassed studies published from inception to March 2023. Cohort studies were included that examined the relationship between preprocedural CA-125 levels and mortality or HF readmission at 12 months in TAVR patients. Crude (cHR) and adjusted hazard ratios (aHR) with their corresponding 95% confidence intervals (CI) were pooled using a random-effects model. The risk of bias was assessed using the QUIPS tool, and the certainty of evidence was evaluated using the GRADE approach. A total of five cohort studies involving 1594 patients were included in the analysis.
The meta-analysis revealed a significant association between higher levels of CA-125 and an increased risk of mortality or HF readmission at 12 months. Both crude and adjusted effect estimates demonstrated this association, with a cHR of 2.79 (95% CI 1.45–5.36, I2 = 72%) and aHR of 3.27 (95% CI 2.07–5.18, I2 = 0%, high certainty), respectively. Furthermore, elevated CA-125 levels were also found to be associated with increased mortality, as indicated by crude (cHR 2.68, 95% CI 1.99–3.60, I2 = 0%) and adjusted (aHR 2.17, 95% CI 1.54–3.07, I2 = 0%, high certainty) effect estimates. The risk of bias across the included studies ranged from low to moderate.
Based on the findings of this systematic review and meta-analysis, it can be concluded that higher preprocedural CA-125 levels are associated with an increased risk of mortality or HF readmission at 12 months in patients undergoing TAVR. These results suggest that CA-125 may have incremental prognostic value in guiding treatment decisions for this patient population. However, further studies are warranted to fully elucidate the clinical utility of CA-125 and its potential role in informing treatment strategies for TAVR patients.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24064
References Diaz‐Arocutipa, C., Saucedo‐Chinchay, J., & Mamas, M. A. (2023). Prognostic role of CA-125 in patients undergoing transcatheter aortic valve replacement: A systematic review and meta-analysis. Clinical Cardiology, 46(10), 1129–1136. https://doi.org/10.1002/clc.24064
