Carbohydrate Antigen 125: An Predictor In Fluid Overload And In-Hospital Outcomes Of Heart Failure Patients

Abstract

Background: Congestion is the main mechanism leading to disease progression and an important therapeutic target in heart failure (HF). Therefore, early detection of fluid overload in HF patients is essential. In recent years, increasing evidence has supported the use of carbohydrate antigen 125 (CA125) in cardiovascular diseases, particularly HF, with many studies worldwide demonstrating an association between CA125 levels and the degree of fluid overload. Before CA125, several prognostic biomarkers such as natriuretic peptides, high-sensitivity troponin, proadrenomedullin, soluble ST2, and galectin-3 had been evaluated. Despite the effectiveness of some prognostic markers, it remains challenging to identify predictors that can provide reliable prognostic information within a short timeframe for patients with acute heart failure (AHF). Methods: A prospective cohort study was conducted on 122 patients with heart failure who were hospitalized and treated at the Department of General Internal Medicine, Binh Chanh General Hospital, from March 2025 to September 2025. Results: There were 90 cases (74.6%) with fluid overload. The mean age was 68.1 ± 13.5 years, and 52.5% were male. The CA125 cutoff value for predicting fluid overload was >11.36 U/mL, with an AUC of 0.764 (95% CI: 0.66–0.87, p < 0.001), sensitivity of 85%, and specificity of 65%. At the cut-off point of 36.06, CA 125 had a sensitivity of 0.86 and a specificity of 0.72 in predicting in-hospital outcomes in patients with heart failure. Conclusion: CA125 demonstrates good accuracy in predicting fluid overload and in-hospital outcomes in patients with heart failure.