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. 2021 Aug 16;11(1):16548.
doi: 10.1038/s41598-021-95990-9.

Prognostic role of neoplastic markers in Takotsubo syndrome

Francesco Santoro  1   2 , Tecla Zimotti  1 , Adriana Mallardi  1 , Alessandra Leopizzi  1 , Enrica Vitale  1 , Nicola Tarantino  3 , Armando Ferraretti  4 , Antonio Giovanni Solimando  5   6 , Vito Racanelli  5 , Massimo Iacoviello  1 , Michele Cannone  2 , Matteo Di Biase  1 , Natale Daniele Brunetti  7
Affiliations

Prognostic role of neoplastic markers in Takotsubo syndrome

Francesco Santoro et al. Sci Rep. .

Abstract

Takotsubo syndrome (TTS) is an acute heart failure syndrome with significant rates of in and out-of-hospital mayor cardiac adverse events (MACE). To evaluate the possible role of neoplastic biomarkers [CA-15.3, CA-19.9 and Carcinoembryonic Antigen (CEA)] as prognostic marker at short- and long-term follow-up in subjects with TTS. Ninety consecutive subjects with TTS were enrolled and followed for a median of 3 years. Circulating levels of CA-15.3, CA-19.9 and CEA were evaluated at admission, after 72 h and at discharge. Incidence of MACE during hospitalization and follow-up were recorded. Forty-three (46%) patients experienced MACE during hospitalization. These patients had increased admission levels of CEA (4.3 ± 6.2 vs. 2.2 ± 1.5 ng/mL, p = 0.03). CEA levels were higher in subjects with in-hospital MACE. At long term follow-up, CEA and CA-19.9 levels were associated with increased risk of death (log rank p < 0.01, HR = 5.3, 95% CI 1.9-14.8, HR = 7.8 95% CI 2.4-25.1, respectively, p < 0.01). At multivariable analysis levels higher than median of CEA, CA-19.9 or both were independent predictors of death at long term (Log-Rank p < 0.01). Having both CEA and CA-19.9 levels above median (> 2 ng/mL, > 8 UI/mL respectively) was associated with an increased risk of mortality of 11.8 (95% CI 2.6-52.5, p = 0.001) at follow up. Increased CEA and CA-19.9 serum levels are associated with higher risk of death at long-term follow up in patients with TTS. CEA serum levels are correlated with in-hospital MACE.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Serum levels of CEA, CA15-3 and CA-19-9 during hospitalization according to incidence of adverse events during hospitalization. *p < 0.05.
Figure 2
Figure 2
Kaplan Meier curves, showing survival rates according to CEA and CA-19.9 over median values.
Figure 3
Figure 3
Kaplan Meier curves, showing survival rates in patients with levels of CEA and CA-19.9 over median values or both.
See this image and copyright information in PMC

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