Evaluation of CA125 and NT-proBNP values in patients undergoing transcatheter aortic valve implantation

Hüseyin Ayhan; Hacı Ahmet Kasapkara; Tahir Durmaz; Telat Keleş; Cenk Sarı; Serdal Baştuğ; Kemal Eşref Erdoğan; Nihal Akar Bayram; Emine Bilen; Murat Akçay; Engin Bozkurt

doi:10.11909/j.issn.1671-5411.2015.02.002

Evaluation of CA125 and NT-proBNP values in patients undergoing transcatheter aortic valve implantation

J Geriatr Cardiol. 2015 Mar;12(2):100-6. doi: 10.11909/j.issn.1671-5411.2015.02.002.

Affiliations

¹ Faculty of Medicine, Department of Cardiology, Yıldırım Beyazıt University, Ankara 06800, Turkey.
² Department of Cardiology, Ankara Ataturk Education and Research Hospital, Ankara 06800, Turkey.
³ Faculty of Medicine, Department of Cardiovascular Surgery, Yıldırım Beyazıt University, Ankara 06800, Turkey.

PMID: 25870611
PMCID: PMC4394323
DOI: 10.11909/j.issn.1671-5411.2015.02.002

Abstract

Background: Transcatheter aortic valve implantation (TAVI) is a minimally invasive, emerging therapy in surgically high risk, or inoperable patients. Parameters used for risk classification have some deficiencies in the selection of patients. The objective of this study is to evaluate the impact of TAVI on carbohydrate antigen 125 (CA125) and N-Terminal pro Brain-type Natriuretic Peptide (NT-proBNP) as biomarkers that have been used frequently in recent years, and also the relationship of these biomarkers to prognosis.

Methods & results: Transcatheter aortic valve implantation was practiced on 31 patients in this study. Then, CA125 and NT-proBNP levels studied in patients prior to and after the TAVI were evaluated. The patients were also grouped in accordance with their left ventricular ejection fraction (LVEF) and CA125 levels (LVEF ≥ 40% and < 40%; CA125 ≤ 35 U/L and > 35 U/L). The TAVI operation was successfully performed in all patients. There was no in-hospital mortality and substantial improvement in functional capacity was detected at follow ups. In addition, a statistically significant decrease was detected in post-TAVI CA125 and NT-proBNP levels of all patients (CA125 83.8 ± 18.1 U/L vs. 64.3 ± 14.2 U/L, P = 0.008; NT-proBNP: 4633.6 ± 627.6 pg/mL vs. 2866.3 ± 536.8 pg/mL, P < 0.001). In groups divided according to the CA125 levels, there was also statistically significant post-TAVI decline in CA125 levels. Within CA125 > 35 U/L and LVEF < 40% groups, the permanent need for a pacemaker was required in one (3.2%) patient and mortality was observed in two (6.4%) patients after TAVI at follow up.

Conclusions: The results show that TAVI can be performed effectively and reliably in patients with high baseline levels of CA125 and NT-proBNP. These biomarkers are reduced substantially with TAVI, while high biomarker levels are associated with undesired events, and certainly, these biomarkers can be used for risk classifications in patient selection for TAVI.

Keywords: B-type natriuretic peptide; Biomarker; Carbohydrate antigen; Heart failure; Risk score; Transcatheter aortic valve implantation.