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. 2023 Feb;93(3):682-688.
doi: 10.1038/s41390-022-02130-8. Epub 2022 Jun 15.

CA125: a novel cardiac biomarker for infants with congenital diaphragmatic hernia

Lukas Schroeder  1 , Flaminia Pugnaloni  2 , Ramona Dolscheid-Pommerich  3 , Annegret Geipel  4 , Christoph Berg  4   5 , Stefan Holdenrieder  6 , Andreas Mueller  7 , Florian Kipfmueller  7
Affiliations

CA125: a novel cardiac biomarker for infants with congenital diaphragmatic hernia

Lukas Schroeder et al. Pediatr Res. 2023 Feb.

Abstract

Background: The carbohydrate antigen 125 (CA125) was proven as a robust biomarker for risk stratification in adults with heart failure. This is the first study analyzing CA125 in a cohort of infants with congenital diaphragmatic hernia (CDH).

Methods: Sixty-eight infants with CDH, treated at the University Children's Hospital Bonn (Germany), between January 2018 and February 2021, were prospectively enrolled for analysis. CA125 values were measured at the following timepoints: 6,12, 24, 48 h, and during ECMO daily from day 1 to day 7.

Results: In infants not surviving to discharge, CA125 values were significantly higher at day 1 (6, 12, and 24 h). Infants with subsequent need for ECMO presented significantly higher CA125 values at 12 h of life. During ECMO, CA125 values measured at day 1 were significantly higher in infants not surviving to discharge. In the ROC analysis, a CA125 value of ≥10 U/ml was calculated as optimal cut-off for the prediction of ECMO and in-hospital mortality. CA125 values correlated significantly with the severity of PH and ventricular dysfunction.

Conclusions: CA125 values correlate significantly with echocardiographic markers of PH and ventricular dysfunction and correlate significantly with parameters of disease severity (need for ECMO, mortality).

Impact: CA125 was proven as robust cardiac biomarker in adult cohorts. Information about the utility as a biomarker in neonatal cohorts is lacking. This is the first study analyzing CA125 as a cardiac biomarker in a cohort of infants with congenital diaphragmatic hernia (CDH). CA125 correlates significantly with markers of echocardiographic assessment (PH and ventricular dysfunction) in infants with CDH and helps to identify infants at high risk for ECMO and in-hospital mortality. The results underline the need for the inclusion of cardiac biomarkers in the clinical routine in neonates at risk for cardiopulmonary failure.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Analysis of CA125 values and outcome parameters.
Illustration of CA125 values during first 48 h and subgroup analysis regarding the following parameters: a ECMO/early death and b in-hospital mortality. p Values <0.05 are highlighted in the figure.
Fig. 2
Fig. 2. Analysis of CA125 values and ECMO treatment.
Illustration of CA125 values during ECMO (a) and subgroup analysis of in-hospital mortality (b) after weaning from ECMO (prior to discharge). p Values <0.05 are highlighted in the figure. Mild statistical outliers are marked with a sphere (°) and extreme outliers with an asterisk (*).
Fig. 3
Fig. 3. Echocardiographic assessment.
Illustration of echocardiographic evaluation of PH severity (a) and biventricular dysfunction (b).
Fig. 4
Fig. 4. Illustration of ROC analysis for outcome parameters.
ROC curve analysis of CA125 values regarding the primary endpoint ECMO/early death (a) and the secondary endpoint in-hospital mortality (b).
See this image and copyright information in PMC

References

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