Cardiorenal Medicine最新文献

{"title":"Estimating Glucose Disposal Rate and Its Association with All-Cause and Etiologically Specific Mortality in Cardiovascular-Kidney-Metabolic Syndrome among US Adults: Insights from NHANES 1999-2018.","authors":"Xiaohan Ma, Sheng Chen, Jiang He","doi":"10.1159/000545801","DOIUrl":"10.1159/000545801","url":null,"abstract":"<p><strong>Background: </strong>The estimated glucose disposal rate (eGDR) is a useful indicator of insulinresistance. Thisstudy explores its asociation with cadiovascular-kidney-metabolic syndrome (CKM), a relationship that has rarely been investigated. The aim of this research was toexamine potential correlations between eGDR and CKM.</p><p><strong>Methods: </strong>We analyzed data from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2018. eGDR was categorized into three quartiles: Q1, Q2, and Q3. Weighted multivariate cox regression models, competing risk models and restricted cubic spline (RCS) models were applied to investigate the association between eGDR and mortality outcomes, including all-cause and cause-specific mortality. Subgroup analysis was performed to test the robustness of the results.</p><p><strong>Results: </strong>Of the 14,074 patients with CKM, 2,426 died, including 767 from cardio-cerebrovascular disease and 39 from kidney disease. After adjustment for all potential confounders, weighted multivariate cox models showed that eGDR was inversely associated with mortality from all causes and with mortality from cardio-cerebrovascular (p < 0.05), but not with mortality from kidney disease (p > 0.05). The RCS model further confirmed the linear relationship between eGDR all-cause cardio-cerebrovascular, with statistical evidence supporting this (p for nonlinear >0.05). Even when using non-cardiovascular-cerebrovascular mortality as a competitive risk, the adjusted Fine-Gray model demonstrated that eGDR remains an independent predictor of cardiovascular-cerebrovascular mortality (SHR 0.560, 95% CI 0.460-0.680, p < 0.001).</p><p><strong>Conclusion: </strong>Our findings reveal a significant inverse association between eGDR and the risk of both all-cause and cardio-cerebrovascular mortality in patients with CKM. This suggests that higher levels of eGDR are linked to a lower risk of death from these causes, indicating that improving insulin sensitivity may have protective effects on survival outcomes in CKM patients.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"333-346"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Association of Regional Adipose Tissue Deposit with Cardiovascular-Kidney-Metabolic Syndrome.","authors":"In-Jeong Cho, Sang-Eun Lee, Wook Bum Pyun","doi":"10.1159/000545802","DOIUrl":"10.1159/000545802","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular-kidney-metabolic (CKM) syndrome is a condition characterized by the interplay between cardiovascular disease, kidney disease, diabetes, and obesity, resulting in adverse health outcomes. This study aimed to investigate the differential associations between various adipose tissue types and the progression of CKM syndrome, as well as their relationship with the individual components of the syndrome.</p><p><strong>Methods: </strong>We conducted a retrospective review of 441 individuals with preserved left ventricular (LV) systolic function who underwent both transthoracic echocardiography and abdominal computed tomography. LV structural and functional parameters, along with the thickness of epicardial adipose tissue (EAT), perirenal adipose tissue (PAT), and subcutaneous adipose tissue (SAT), were assessed through these imaging modalities. Additionally, the triglyceride and glucose (TyG) index was evaluated as a marker of insulin resistance, while glomerular filtration rate (GFR) was estimated to assess kidney function.</p><p><strong>Results: </strong>EAT and PAT demonstrated a progressive increase in thickness with advancing stages of CKM syndrome, whereas body mass index and SAT did not show similar trends. EAT was predominantly associated with markers of LV diastolic dysfunction, while PAT was uniquely associated with GFR, independent of other adipose tissue. Furthermore, the TyG index was independently correlated with the thickness of both EAT and PAT, but not with SAT thickness.</p><p><strong>Conclusion: </strong>Heart, kidney, and metabolic disorders associated with CKM syndrome demonstrated varying correlations depending on the specific regional adipose tissue depot. EAT and PAT were identified as key regional adipose tissue linked to the progression of CKM syndrome.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"285-294"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early versus Late Acute Kidney Injury in Patients Undergoing Primary Percutaneous Coronary Intervention.","authors":"Inbal Greenberg, Yacov Shacham, Maayan Konigstein, Shmuel Banai, Jeremy Ben-Shoshan","doi":"10.1159/000546496","DOIUrl":"10.1159/000546496","url":null,"abstract":"<p><strong>Introduction: </strong>Acute kidney injury (AKI) frequently complicates ST-elevation myocardial infarction (STEMI) in patients undergoing primary percutaneous coronary intervention (PCI) and is associated with increased short- and long-term mortality. However, the impact of the AKI onset time following PCI on patient outcomes remains uncertain. This study aimed to investigate the timing of post-PCI AKI development and its prognostic significance in STEMI patients.</p><p><strong>Methods: </strong>This retrospective cohort study included 2,912 STEMI patients who underwent successful PCI upon admission. The timing of AKI was determined according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria, using routine blood tests conducted during hospitalization. The primary endpoint was all-cause mortality.</p><p><strong>Results: </strong>Among 2,912 STEMI patients studied, 222 (7.6%) developed AKI. AKI was classified as early if it occurred within 1.5 days (n = 108, 48.6%) or late if it occurred after 1.5 days (n = 114, 51.4%). Early AKI was associated with a significantly higher incidence of cardiogenic shock at presentation, lower post-PCI left ventricular ejection fraction, and increased 30-day mortality compared to late AKI. In a multivariate Cox regression analysis, early AKI emerged as an independent predictor of long-term mortality (adjusted HR 1.8, 95% CI 1.1-2.8, p = 0.015). Additionally, multivariate logistic regression analysis identified cardiogenic shock as a significant predictor of early AKI (adjusted OR 2.3, 95% CI 1.1-4.9, p = 0.03).</p><p><strong>Conclusion: </strong>In STEMI patients, early AKI - compared to late AKI - is associated with higher short- and long-term mortality and occurs more frequently in those presenting with cardiogenic shock.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"526-534"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12252143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cardiac and Renal Safety of Semaglutide in Patients with Type 2 Diabetes: A Real-World Study Based on FAERS.","authors":"Jingyu Wang, Tong Xie, Yuemiao Zhang, Hong Zhang","doi":"10.1159/000546238","DOIUrl":"10.1159/000546238","url":null,"abstract":"<p><strong>Background: </strong>Recently, a large clinical trial found that treatment with semaglutide significantly reduced the risk of renal damage and cardiovascular death in patients with type 2 diabetes (T2D). To validate these findings and ensure the suitability of the drug, it is necessary to address the renal and cardiac safety of semaglutide in patients with T2D through real-world safety evidence.</p><p><strong>Methods: </strong>We examined post-marketing data on the use of semaglutide in patients with T2D using disproportionality analysis based on the FDA Adverse Event Reporting System database. We focused on the detection of positive signals for acute and chronic renal injury and cardiac adverse events associated with semaglutide therapy.</p><p><strong>Results: </strong>A total of 2,380 patients were enrolled in semaglutide therapy in T2D patients with no renal or cardiac positive signals in four algorithmic thresholds, including disproportionality analysis.</p><p><strong>Conclusions: </strong>In the current study, we observed no significant cardiac or renal safety signals in patients with T2D treated with semaglutide. Our results provide further support for its use as initial and combination therapy in relevant populations.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"413-422"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Serum Polyamines with Cardiovascular Events and All-Cause Mortality in Chronic Kidney Disease.","authors":"Zijin Chen, Shaobo Wang, Li Liu, Liangyu Yin, Xinli Xu, Jiachuan Xiong, Jinghong Zhao","doi":"10.1159/000545054","DOIUrl":"10.1159/000545054","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence indicates that serum polyamines, including putrescine, spermidine, and spermine, may serve as potential biomarkers for chronic kidney disease (CKD) and its progression. However, the association between serum polyamine levels, cardiovascular (CV) events, and mortality in CKD patients remains poorly understood.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted, involving 297 adult patients with CKD at stages 1-5 from March 2015 to September 2018, with follow-up until May 2023. Serum polyamine levels were quantified using high-performance liquid chromatography and subsequently categorized into quartiles. The Kaplan-Meier curve was employed to assess the survival probabilities of CV events and overall mortality in relation to serum polyamine levels. The relationship between serum polyamines and the risk of cardiovascular disease (CVD) and overall mortality was explored using univariate and multivariate Cox regression analyses. Furthermore, we conducted a competing-risk analysis to investigate the link between serum polyamines and CV events, with mortality as the competing event.</p><p><strong>Results: </strong>Over a median follow-up of 6.11 years, our findings revealed a negative correlation between putrescine levels and estimated glomerular filtration rate (eGFR), while spermidine and spermine levels were positively correlated with eGFR. The Kaplan-Meier curve demonstrated that serum polyamines were significantly associated with risk of CV events and all-cause mortality. Moreover, Cox regression analyses showed that, in a multivariate Cox model, patients in the highest quartile of putrescine displayed a significantly higher risk of CV events (hazard ratio [HR] 6.972, 95% confidence interval [CI] 2.520-19.294, p < 0.001) compared to those in the lowest quartile. Conversely, higher levels of spermidine were associated with a lower risk of CV events (HR = 0.077, 95% CI 0.022-0.274, p < 0.001), and higher levels of spermine also appeared to reduce the risk of CV events (HR = 0.180, 95% CI 0.061-0.530, p = 0.002). The relationship between serum polyamines and CVD remained robust in the competing risk models. Additionally, in the multivariate model, spermidine and spermine showed a significant protective effect on the risk of overall mortality; however, the protective effect was diminished upon the inclusion of eGFR as a covariate.</p><p><strong>Conclusions: </strong>Our study demonstrates significant disruption in serum polyamine levels among CKD patients, which correlates with eGFR. Altered polyamine levels are linked to an increased risk of CV events and overall mortality. Thus, serum polyamines may be considered valuable prognostic indicators for CKD patients.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"238-248"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-Care Ultrasound over Punchlines: Rethinking the Cardiology-Nephrology Standoff in the Era of MedEd Humor.","authors":"Abhilash Koratala, Eduardo R Argaiz, Rafael De La Espriella, Marta Cobo Marcos, Gregorio Romero-González","doi":"10.1159/000546388","DOIUrl":"10.1159/000546388","url":null,"abstract":"","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"423-426"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Hospital Admissions and Death in Patients with Heart Failure and Chronic Kidney Disease: Findings from a Novel Multidisciplinary Clinic.","authors":"Simran Parmar, Tony Lopez, Ronak Shah, Daniel Murphy, Hilary Warrens, Marwa Khairallah, Lisa Anderson, Giuseppe Rosano, Irina Chis Ster, Debasish Banerjee","doi":"10.1159/000541806","DOIUrl":"10.1159/000541806","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with heart failure (HF) and chronic kidney disease (CKD) are often suboptimally treated due to concerns of hyperkalaemia, declining kidney function, and hypotension. They commonly suffer from fluid overload which can lead to frequent hospitalisations and death. This research aims to determine the characteristics associated with hospital admissions and death in patients with CKD and HF.</p><p><strong>Methods: </strong>Consecutive patients with CKD stage 3-5 and HF (regardless of ejection fraction) attending a large, specialised CKD-HF clinic between 12/Sept/2019 and 11/Nov/2021 were identified and data were collected on demographic factors, renal and heart function, medications, hospitalisations, and death. Multinomial and Cox regressions determined the characteristics of patients requiring hospitalisation and their risk of death, respectively.</p><p><strong>Results: </strong>A total of 667 admissions were attributable to 318 patients, 201 admissions were for HF. Men were less likely than women to have been admitted to hospital for HF (risk ratio [RR] 0.43, 95% CI 0.20, 0.94) and non-HF causes (RR 0.21, 95% CI 0.10, 0.47). A serum haemoglobin level greater than 100 g/L was associated with fewer HF and non-HF admissions compared to a serum haemoglobin less than 100 g/L (RR 0.26, 95% CI 0.09, 0.74; RR 0.17, 95% CI 0.06, 0.47). Compared to CKD stage 3, CKD stage 4 was associated with an increased risk of HF and non-HF admissions (RR 4.01, 95% CI 1.04, 15.5; RR 4.33, 95% CI 1.13, 16.5). Having a HF admission (HR 2.41, 95% CI 1.27, 4.60), HFrEF (HR 2.18, 95% CI 1.30, 3.63), CKD stage 4 (HR 1.91, 95% CI 1.16, 3.16), and loop diuretic use (HR 2.24, 95% CI 1.14, 4.40) were associated with a significantly increased risk of death compared to people with no admissions, with HF with reduced preserved ejection fraction, CKD stage 3, and no diuretic use, respectively. The use of RAAS inhibitors halved the risk of death compared to non-prescribed patients (HR 0.44, 95% CI 0.27, 0.72).</p><p><strong>Conclusion: </strong>Hospital admissions among CKD-HF patients were common, particularly in those with lower serum haemoglobin levels and advanced CKD stage. The risk of death was higher in those with HF admissions, the presence of HFrEF, advanced CKD stage, loop diuretic use, and those not prescribed RAAS inhibitors.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"249-260"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunosuppressive Therapy-Related Cardiovascular Risk Factors in Renal Transplantation: A Narrative Review.","authors":"Chiara Paccagnella, Stefano Andreola, Alessia Gambaro, Giovanni Gambaro, Chiara Caletti","doi":"10.1159/000542378","DOIUrl":"10.1159/000542378","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplantation is the best treatment for patients with chronic renal failure, capable of improving life expectancy and the risk of death from all causes, which, however, remains higher than in the general population. The leading cause of death in transplant patients is cardiovascular events, burdened by a significant impact brought about by anti-rejection therapy. Experimental and clinical studies to date show that in kidney transplant recipients, traditional cardiovascular risk factors (hypertension, diabetes, dyslipidemia, obesity, tobacco, etc.) may be exacerbated or worsened by the dysmetabolic effects of immunosuppressive drugs, which may also result in additional risk factors such as proteinuria, anemia, and arterial stiffness. The aim of this review was to provide an in-depth evaluation of the effect of immunosuppressive treatments on cardiovascular risk factors.</p><p><strong>Summary: </strong>We have investigated and described the main cardiovascular risk factors related to immunosuppressive drugs. We searched for relevant scientific articles in medicine, transplant, cardiologic, and nephrological journals in major medical science libraries.</p><p><strong>Key messages: </strong>Immunosuppressive drugs allow graft survival and successful bunking of the transplant; however, they are not without significant side effects and should always be prescribed weighing the risk/benefit ratio and the individual patient's therapeutic needs.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"209-228"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EMCREG-International Multidisciplinary Consensus Panel on Management of Hyperkalemia in Chronic Kidney Disease and Heart Failure.","authors":"Natalie Kreitzer, Nancy M Albert, Alpesh N Amin, Craig J Beavers, Richard C Becker, Gregg Fonarow, W Brian Gibler, Katherine W Kwon, Robert J Mentz, Biff F Palmer, Charles V Pollack, Ileana L Piña","doi":"10.1159/000543385","DOIUrl":"10.1159/000543385","url":null,"abstract":"<p><strong>Background: </strong>Hyperkalemia, generally defined as serum potassium levels greater than 5.0 mEq/L, poses significant clinical risks, including cardiac toxicity and muscle weakness. Its prevalence and severity increase in patients with chronic kidney disease (CKD), diabetes mellitus, and heart failure (HF), particularly when compounded by medications like angiotensin converting inhibitors, angiotensin receptor blockers, and potassium sparing diuretics. Hyperkalemia arises from disruptions in potassium regulation involving intake, excretion, and intracellular-extracellular distribution. In CKD and acute kidney injury, these regulatory mechanisms are impaired, leading to heightened risk. The management of chronic hyperkalemia presents a challenge due to the necessity of balancing effective cardiovascular and renal therapies against the risk of elevated potassium levels.</p><p><strong>Summary: </strong>The emergency department management of acute hyperkalemia focuses on preventing cardiac complications through strategies that stabilize cellular membranes and shift potassium intracellularly. Chronic management often involves dietary interventions and pharmacological treatments. Pharmacological management of acute hyperkalemia includes diuretics, which enhance kaliuresis, and potassium binders such as patiromer and sodium zirconium cyclosilicate, which facilitate fecal excretion of potassium. While diuretics are commonly used, they carry risks of volume contraction and renal function deterioration. The newer potassium binders have shown efficacy in lowering chronically elevated potassium levels in CKD and HF patients, offering an alternative to diuretics and other older agents such as sodium polystyrene sulfonate, which has significant adverse effects and limited evidence for chronic use.</p><p><strong>Key messages: </strong>We convened a consensus panel to describe the optimal management across multiple clinical settings when caring for patients with hyperkalemia. This consensus emphasizes a multidisciplinary approach to managing hyperkalemia, particularly in patients with cardiovascular kidney metabolic syndrome, to avoid fragmentation of care and ensure comprehensive treatment strategies. The primary goal of this manuscript is to describe strategies to maintain cardiovascular benefits of essential medications while effectively managing potassium levels.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"133-152"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Antigen Carbohydrate 125 in Patients Receiving Dapagliflozin following an Admission for Acute Heart Failure.","authors":"Gema Miñana, Rafael de la Espriella, Miguel Lorenzo-Hernández, Enrique Rodriguez-Borja, Anna Mollar, Patricia Palau, Agustin Fernández-Cisnal, Ernesto Valero, Arturo Carratalá, Enrique Santas, Vicent Bodi, Juan Sanchis, Antoni Bayés-Genís, Eduardo Nuñez, Julio Nuñez","doi":"10.1159/000543417","DOIUrl":"10.1159/000543417","url":null,"abstract":"<p><strong>Introduction: </strong>Antigen carbohydrate 125 (CA125) has emerged as a proxy of fluid overload and inflammation in acute heart failure (AHF). We aimed to evaluate the influence of dapagliflozin on CA125 levels within the first weeks after discharge and whether CA125 changes were related to 6-month adverse clinical outcomes.</p><p><strong>Methods: </strong>In this retrospective observational study, data from 956 AHF patients discharged from a tertiary hospital were analyzed. CA125 levels were assessed during the index admission (visit 1) and at a median of 26 (15-39) days after discharge (visit 2). The primary endpoint was changes in CA125 and its correlation with the risk of 6-month death and recurrent readmissions (any or AHF-related). Multivariable mixed regression and a two-equation count model regression were used for the analyses.</p><p><strong>Results: </strong>The mean age of the cohort was 73.1 ± 11.1 years, 54.8% were males, 43.5% showed left ventricular ejection fraction ≥50%, and 18.7% of patients received dapagliflozin at discharge. Dapagliflozin treatment was associated with a greater reduction in CA125 levels at follow-up (-24 U/mL) compared to non-dapagliflozin patients (-14 U/mL, p = 0.034). The magnitude of CA125 reduction (per decrease in 10 U/mL) was significantly associated with a lower risk of 6-month death (incidence rate ratio [IRR] = 0.98, 95% CI = 0.96-0.99; p = 0.049), all-cause readmissions (IRR = 0.99, 95% CI = 0.98-0.99; p = 0.003), and HF readmissions (IRR = 0.98, 95% CI = 0.97-0.99; p < 0.001).</p><p><strong>Conclusion: </strong>Dapagliflozin treatment at discharge following an episode of AHF was associated with a greater reduction in CA125 during the first weeks after discharge. The greater CA125 reduction identified patients with a lower risk of 6-month adverse clinical outcomes.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"122-132"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}