Carbohydrate antigen 125 predicts pulmonary congestion in patients with ST-segment elevation myocardial infarction.

Carbohydrate antigen 125 (CA125) has long been used as an ovarian cancer biomarker. However, because it is not specific for ovarian cells, CA125 could also be used to monitor congestion and inflammation in heart disease. Acute heart failure (HF) is used to identify patients with a worse prognosis in ST-segment elevation myocardial infarction (STEMI). We aimed to determine the association of CA125 with acute HF in STEMI and to compare CA125 with N-terminal pro brain natriuretic peptide (NTproBNP) with a cross-sectional study. At admission, patients were examined to define Killip class and then underwent coronary angioplasty. Blood samples, preferably taken in the hemodynamic ward, were centrifuged (1500 g for 15 min at ambient temperature) and stored at -80°C until biomarker assays were performed. Patients were divided into two groups according to the presence or absence of congestion. Patients in Killip class ≥II were in the congestion group and those with Killip

Carbohydrate antigen 125 predicts pulmonary congestion in patients with ST-segment elevation myocardial infarction

Carbohydrate antigen 125 (CA125) has long been used as an ovarian cancer biomarker. However, because it is not specific for ovarian cells, CA125 could also be used to monitor congestion and inflammation in heart disease. Acute heart failure (HF) is used to identify patients with a worse prognosis in ST-segment elevation myocardial infarction (STEMI). We aimed to determine the association of CA125 with acute HF in STEMI and to compare CA125 with N-terminal pro brain natriuretic peptide (NTproBNP) with a cross-sectional study. At admission, patients were examined to define Killip class and then underwent coronary angioplasty. Blood samples, preferably taken in the hemodynamic ward, were centrifuged (1500 g for 15 min at ambient temperature) and stored at −80°C until biomarker assays were performed. Patients were divided into two groups according to the presence or absence of congestion. Patients in Killip class ≥II were in the congestion group and those with Killip <II in the absence of congestion group. We evaluated 231 patients. The mean age was 63.3 years. HF at admission was identified in 17.7% of patients. CA125 and NTproBNP levels were higher in patients with Killip class ≥II than those with Killip class <II (8.03 vs 9.17, P=0.016 and 772.45 vs 1925, P=0.007, respectively). The area under the receiver operator characteristic curve was 0.60 (95%CI 0.53−0.66, P=0.024) for CA125 and 0.63 (95%CI 0.56−0.69, P=0.001) for NTproBNP. There was no statistical difference between the curves (P=0.69). CA125 has similar use to NTproBNP in identifying acute HF in patients presenting with STEMI.

Quality of life in patients with osteoporosis fractures: cultural adaptation, reliability and validity of the Osteoporosis Assessment Questionnaire.

OBJECTIVE: The purpose of this study was to translate into Brazilian-Portuguese the Osteoporosis Assessment Questionnaire (OPAQ), and to evaluate its reliability and validity. METHODS: The OPAQ was translated into Brazilian-Portuguese. This version was then back-translated into an English version which was compared to the original version, and a second Brazilian-Portuguese version was generated. This draft version of the Brazilian-Portuguese OPAQ was administered to 30 patients with lumbar osteoporosis and no fractures. The non-applicable questions were modified and, after being administered again, this Brazilian-Portuguese version of the OPAQ was accepted as definitive. Its reliability was tested in 30 osteoporotic out-patients, and was administered three times to the patients to check the intra/interobserver reliability. The patients were also clinically evaluated using HAQ, FIQ and a numerical rating scale for pain. For all patients the number of fractures and the bone mineral density at the spine were determined. RESULTS: The mean age of the patients was 69 years (54 to 89 years) and the mean number of fractures was 2.72. Twenty-one patients (70%) had had more than one vertebral fracture. All of the questionnaire components, except for mood (c16), presented statistically significant coefficients for intra/interobserver reliability. The highest score was observed for "the fear of falling" (6.70). Correlations between the OPAQ components and the number of fractures, bone density and Z-score were not statistically significant. CONCLUSIONS: This Brazilian-Portuguese version of the OPAQ is a reliable and valid instrument. Other aspects than bone mineral density and the number of fractures have an important influence on the quality of life in patients with osteoporosis and fractures.