Author + information
- Oliver Husser,
- Julio Nunez,
- Eduardo Nunez,
- Andreas Holzamer,
- Günter Riegger,
- Christof Schmid,
- Michael Hilker and
- Christian Hengstenberg
Risk stratification after transcatheter aortic valve replacement (TAVR) remains challenging. Biomarkers may be useful in this setting. We studied the predictive value of tumor marker carbohydrate antigen 125 (CA125) before and after TAVR for all–cause death and a composite endpoint of death, heart failure, myocardial infarction and stroke (MACE).
CA125 was measured in 228 patients before and after TAVR. The association with outcomes was assessed using parametric Cox regression and joint modeling for baseline and longitudinal analyses. Logarithmic CA125 and dichotomized by its median (M1:≤15.7 vs. M2:>15.7 U/ml).
At a median follow–up of 183 days, 50 patients (22%) died and 75 (33%) had MACE. A 3–fold increase in the rates for death and MACE was observed in patients above the median (M2 vs. M1) of CA125 (5.2 vs. 1.6 and 8.3 vs. 3.3 per 10 person–years, respectively; p for both <.001). Event free survival was worse for both endpoints in M2 vs. M1 (figure). In a multivariable analysis adjusted for logistic EuroScore, NYHA class III/IV and device success, baseline values of CA125 (M2 vs. M1) independently predicted death (hazard ratio (HR 2.18, 95%CI [1.11–4.26], p=.023) and MACE (HR 1.77, 95%CI [1.05–2.98], p=.031). lnCA125 as a time–varying exposure, was highly associated with both endpoints: HR 1.47, 95%CI [1.01–2.14], p=.043 and HR 2.26, 95%CI [1.28–3.98], p=.005, for death and MACE respectively.
CA125 before and after TAVR independently predicts death and MACE.
Moderated Poster Contributions
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.–4:30 p.m.
Session Title: TAVR I: Predictors of TAVR Outcomes Including LVEF, Contractile Reserve, BNP, Pulmonary HTN, CA 125, and Fever
Abstract Category: 32. Valvular Heart Disease: Therapy
Presentation Number: 1156M–90
- 2013 American College of Cardiology Foundation