Clinical Role of CA125 in Worsening Heart Failure A BIOSTAT-CHF Study Subanalysis

OBJECTIVES The aim of this study was to evaluate the association between antigen carbohydrate 125 (CA125) and the risk of 1-year clinical outcomes in patients with worsening heart failure (HF).BACKGROUND CA125 is a widely available biomarker that is up-regulated in patients with acute HF and has been postulated as a useful marker of congestion and risk stratification.METHODS hi a large multicenter cohort of patients with worsening HF, either in-hospital or in the outpatient setting, the independent associations between CA125 and 1-year death and the composite of death/HF readmission (adjusted for outcome-specific prognostic risk score [BIOSTAT risk score]) were determined by using the Royston-Parmar method (N = 2356). In a sensitivity analysis, the prognostic implications of CA125 were also adjusted for a composite congestion score (CCS). Data were validated in the B1OSTAT-CHF (Biology Study to Tailored Treatment in Chronic Heart Failure validation) cohort (N = 1,630).RESULTS Surrogates of congestion, such as N-terminal pro-B-type natriuretic peptide and CCS, emerged as independent predictors of CA125. In muttivariabte survival analyses, higher CA125 was associated with an increased risk of mortality and the composite of death/HF readmission (p &lt;0.001 for both comparisons), even after adjustment for the CCS (p &lt;0.010 for both comparisons). The addition of CA125 to the B1OSTAT score led to a significant risk reclassification for both outcomes (category-free net reclassification improvement 0.137 [p &lt;0.001] and 0.104 [p 0.003] respectively). AR outcomes were confirmed in an independent validation cohort.CONCLUSIONS In patients with worsening HF, higher levels of CA125 were positively associated with parameters of congestion. Furthermore, CA125 remained independently associated with a higher risk of clinical outcomes, even beyond a predefined risk model and clinical surrogates of congestion. (C) 2020 by the American College of Cardiology Foundation.</p

Representación gráfica Onda QRS2 - ECG

[ES] Los datos representan los valores numéricos para la representación de la onda QRS2 de un electrocardiogramaSantiago Praderas, VM.; Taroncher Pellicer, L.; Fernandez Cisnal, A. (2021). Representación gráfica Onda QRS2 - ECG. https://doi.org/10.4995/Dataset/10251/16321

Rationale and design of a multicenter, international and collaborative coronary artery aneurysm registry (CAAR)

Coronary artery aneurysm has been classically defined as a coronary dilation that exceeds the diameter of normal adjacent segments or the diameter of the patient’s largest coronary vessel by 1.5×. Termed by Bourgon,1 it is an uncommon disease that has been diagnosed with increasing occurrence since the advent of coronary angiography.2,3 The incidence has been reported to vary from 1.5% to 5%, with suggested male dominance and a predilection for the right coronary artery.2,3 Although several causes have been shown, atherosclerosis accounts for ≥50% of coronary aneurysms in adults. Reported complications include thrombosis and distal embolization, vasospasm, and rupture, producing ischemia, heart failure, or arrhythmias. The natural history and long-term outcomes remain unclear, as definitive data are lacking. In addition, controversies persist regarding the use of medical treatment (antithrombotic therapy) or interventional/surgical procedures.1–

Coronary artery aneurysms, insights from the international coronary artery aneurysm registry (CAAR)

Background: Coronary Aneurysms are a focal dilatation of an artery segment &gt;1.5-fold the normal size of adjacent segments. Although some series have suggested a prevalence of 0.3–12%, data are lacking. In addition, they are not mentioned in practice guidelines. Our aim was investigate its prevalence, management and long-term outcomes. Methods and results: The coronary artery aneurysm registry (CAAR) involved 32 hospitals across 9 countries in America and Europe. We reviewed 436,467 consecutive angiograms performed over the period 2004–2016. Finally, 1565 patients were recruited. Aneurysm global prevalence was 0.35%. Most patients were male (78.5%) with a mean age of 65 years and frequent cardiovascular risk factors. The main indication for angiogram was an acute coronary syndrome, 966 cases. The number of aneurisms was ≤2 per patient in 95.8% of the cases, mostly saccular, most frequently found in the left anterior descending and with numbers proportional with coronary stenosis. Aortopathies were related with more aneurysms too. Most patients received any revascularization procedure (69%), commonly percutaneous (53%). After a median follow-up of 37.2 months, 485 suffered a combined event (MACE) and 240 died. Without major differences comparing CABG vs PCI, MACE and death were more frequent in patients who received bare metal stents. Conclusions: Coronary artery aneurysms are not uncommon. Usually, they are associated with coronary stenosis and high cardiovascular risk. Antiplatelet therapy seems reasonable and a percutaneous approach is safe and effective