• 作者：Julio Nú ; &#241 ; ez^a ; ^{yulnunez@gmail.com} ; Juan Sanchis^a ; Eduardo Nú ; &#241 ; ez^a ; Gregg C. Fonarow^b ; Vicent Bodí ; ^a ; Vicente Bertomeu-Gonzá ; lez^c ; Gema Mi&#241 ; ana^a ; Patricia Palau^a ; Lorenzo Fá ; cila^d ; Francisco J. Chorro^a ; Vicente Bertomeu-Martí ; nez^c ; Angel Llà ; cer^a
• 关键词：CA125 ; antí ; geno carbohidrato 125 ; IC ; insuficiencia cardiaca ; ICA ; insuficiencia cardiaca aguda
• 刊名：Revista Espa?ola de Cardiolog¨ªa
• 出版年：2011
• 出版时间：December 2011
• 年：2011
• 卷：64
• 期：12
• 页码：1100-1108
• 全文大小：461 K

Introduction and objectives

The prognostic benefit of statins in patients with heart failure is a topic of controversy. Under the hypothesis that statins may provide greater benefit in a subgroup of patients with heightened inflammatory activity, we sought to explore whether statins are associated with a decreased risk of long-term mortality in patients with acute heart failure based on elevated levels of carbohydrate antigen 125, a biomarker related to systemic congestion and proinflammatory status.

Methods

We analysed 1222 consecutive patients admitted with acute heart failure in a single teaching center during a median follow-up of 20 months. carbohydrate antigen 125 was measured during index hospitalization and dichotomized according to the established reference cut-off (>35 U/mL).

Results

Increased levels of carbohydrate antigen 125 (>35 U/mL) were observed in 793 (64.9 % ) and prescription of statins registered in 455 (37.2 % ) patients. In patients with carbohydrate antigen 125 >35 U/mL, mortality was lower in statin-treated patients (1.89 vs 2.80 per 10 patient-years of follow-up, P <.001). Conversely, in those with carbohydrate antigen 125 in normal range, mortality did not differ (1.76 vs 1.63 per 10 patient-years of follow-up, P?=?.862). After covariate adjustment, this differential effect persisted (P for interaction =?.024) and statin use was associated with a significant mortality reduction in patients with elevated values of carbohydrate antigen 125 (hazard ratio=0.65, 95 % confidence interval: 0.51-0.82; P?<.001), but not in those with values equal to or below 35 U/mL (hazard ratio=1.02, 95 % confidence interval: 0.74-1.41; P?=?.907).

Conclusions

Elevation of carbohydrate antigen 125 (>35 U/mL) identified a subset of patients with acute heart failure who could benefit from statin treatment in regard to total mortality.

Full English text available from: