Relationship between serum CA125 level and atrial fibrillation in patient with systolic heart failure

FU Jingjing; DAI Xiaoli; XIE Junmin; ZHAO Wenpeng; JIA Xinwei; WANG Yanfei; LI Xiangxin; ZHANG Minxiu; ZHANG Hao

doi:10.3969/j.issn.1002-266X.2018.01.002

Abstract：Objective To investigate the correlation between the serum carbohydrate antigen CA 125 and atrial fibrilla-tion in patients with systolic heart failure and to discuss the best boundary value for predicting the occurrence of atrial fibril -lation.Methods Totally 125 patients with systolic heart failure were divided into two groups according to the results of ECG:the sinus rhythm group ( n=80 ) and the atrial fibrillation group ( n=45 ) .Enzyme linked immunosorbent assay (ELISA) was used to measure the serum CA125 concentration, and to analyze the correlations of serum CA125 concentra-tion with ejection fraction , pulmonary artery systolic blood pressure , mitral regurgitation , three regurgitation , left atrial di-ameter, pericardial effusion, alanine aminotransferase, creatinine, and hemoglobin concentration.The ROC curve was used to analyze the optimal cut-off level of serum CA 125 for predicting the occurrence of atrial fibrillation in patients with systolic heart failure .Results Significant difference was found in the concentration of serum CA 125 between the atrial fibrillation group and the sinus rhythm group [(65 ±10) vs.(34 ±9) U/mL, P<0.05].The concentration of CA125 was positively correlated with pulmonary artery systolic pressure , mitral regurgitation , tricuspid regurgitation , left atrial diameter , pericar-dial effusion, alanine aminotransferase and creatinine (r=0.352, 0.536, 0.411, 0.302, 0.576, 0.237, and 0.275, all P<0.05).On the contrary, it was negatively correlated with the ejection fraction and hemoglobin ( r =-0.223,-0.196;P<0.05).Logistic regression analysis showed that serum CA125, mitral regurgitation (moderate to severe),tricuspid regurgitation ( moderate to severe ) , and diameter of the left atrium separately could predict the occurrence of atrial fibrillation in patients with heart failure (all P<0.05).The increased serum CA125 was related to the occurrence of atrial fibrillation (OR=2.723, 95％ CI=0.917～7.716, P=0.012).The best cut-off point of CA125 for predicting atrial fi-brillation was 44.5 U/mL, and the area under the ROC curve was 0.754 (95％ CI=0.660～0.831, P<0.01), with a sensitivity of 82.22％ and a specificity of 71.2％.Conclusion Serum CA125 could be used to predict the occurrence of atrial fibrillation in patients with systolic heart failure , and the incidence of atrial fibrillation will increase when the concen-tration of serum CA-125 reaches 44.5 U/mL.