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Carbohydrate-antigen-125 levels predict hospital stay duration and adverse events at long-term follow-up in Takotsubo cardiomyopathy

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Abstract

The aim of this study is to evaluate the possible role of carbohydrate-antigen(CA)-125 as prognostic marker at short- and long-term follow-up, in subjects with Takotsubo cardiomyopathy (TTC). Sixty-three consecutive subjects with TTC were enrolled in the study and followed for a median 139 days. Circulating levels of CA-125, NT-proBNP, and left ventricular ejection fraction (LVEF) were evaluated at admission. Duration of hospital stay, incidence of death, re-hospitalization and recurrence of TTC during follow-up were recorded. The mean hospital stay was 8.3 days, adverse events occurred during follow up in 17 % of cases. CA-125 levels at admission are inversely related to LVEF (r −0.30, p < 0.05) and directly related to hospital stay (r 0.29, p < 0.05). CA-125 levels at admission are higher in subjects with adverse events at follow-up (88.9 ± 200.0 vs 20.9 ± 30.0 U/mL, p < 0.05). Rates of incidence of adverse events are proportionally increased with CA-125 tertiles (0, 6, 11 % respectively, p for trend <0.01), at survival analysis (Log Rank p < 0.05) and after correction for age, gender, LVEF and NT-proBNP levels in multivariable Cox analysis (p < 0.05). CA-125 levels <10 U/ml are predictors of adverse events at follow up with 91 % sensitivity, 52 % specificity, 29 % positive predictive power, and 96 % negative predictive power. Increased CA-125 admission levels are associated with a longer hospital stay, a lower LVEF, and a higher risk of adverse events during follow up. CA-125 might be useful for early risk stratification of subjects with TTC.

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Authors and Affiliations

  1. Cardiology Department, University of Foggia, Viale Pinto n.1, 71100, Foggia, Italy

    Francesco Santoro, Armando Ferraretti, Francesco Musaico, Luigi Di Martino, Nicola Tarantino, Riccardo Ieva, Matteo Di Biase & Natale Daniele Brunetti

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  1. Francesco Santoro
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  2. Armando Ferraretti
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  3. Francesco Musaico
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  4. Luigi Di Martino
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  6. Riccardo Ieva
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  7. Matteo Di Biase
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  8. Natale Daniele Brunetti
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Correspondence to Natale Daniele Brunetti.

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The study was conducted in accordance with the amended Declaration of Helsinki.

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Institutional Review Board approved this study as observational and all participant gave a written informed consent before data collection.

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Santoro, F., Ferraretti, A., Musaico, F. et al. Carbohydrate-antigen-125 levels predict hospital stay duration and adverse events at long-term follow-up in Takotsubo cardiomyopathy. Intern Emerg Med 11, 687–694 (2016). https://doi.org/10.1007/s11739-016-1393-y

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