Neoplastic markers in Takotsubo syndrome. Results from a prospective registry

Abstract

Abstract Background Takotsubo syndrome (TTS) is an acute heart failure syndrome with significant rate of in and out-of hospital mayor cardiac adverse events (MACE). Aim of this study 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. Methods Ninety consecutive subjects with TTC were enrolled and followed for a median of 3 years. Circulating levels of CA-15.3, CA-19.9, CEA were evaluated at admission, after 72 h and at discharge. Incidence of MACE during hospitalization and follow-up were recorded. Results Forty-three (46%) patients experienced MACE during hospitalization. These patients were older (78±9 vs 72±12 p=0.01), had lower LVEF (32±7 vs 38±8 p=0,01) and increased levels of CEA (4.3±6.2 vs 2.2±1.5 ng/ml p=0.03). CEA and CA 19.9 levels at admission were statistically correlated with CRP and NT-proBNP levels (both p<0.05). At long term follow-up CEA and CA 19.9 levels (higher than median) were associated with increased risk of death (log rank p<0.01 (both) RR=5.3 CI 95% 1.9–14.8 p<0.01; RR=7.8 CI 95% 2.4–25.1 p<0.01 respectively). At multivariate analysis including age, sex and admission LVEF, CEA and CA 19.9 levels higher than median were an independent predictor of MACE at long term (p<0.01 RR 3.5 CI 1.6–7.3). Conclusion CEA and CA 19.9 serum levels are associated with higher risk of in-hospital MACE and death at long-term. Funding Acknowledgement Type of funding source: None