Changes in Antigen Carbohydrate 125 in Patients Receiving Dapagliflozin following an Admission for Acute Heart Failure

Introduction: Antigen carbohydrate 125 (CA125) hasemerged as a proxy offluid overload and inflammation inacute 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. Methods: In this retrospective observational study, data from 956 AHF patients discharged from a tertiary hospital were analyzed. CA125levels were assessed during the index admission (visit 1) andat 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 atwo-equation count model regression were used for the analyses .Results: 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 as-sociated 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 alower 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).Conclusion: Dapagliflozin treatment at discharge following an episode ofAHF was associated with a greater reduction in CA125 during thefirst weeks after discharge. The greater CA125reduction identified patients with a lower risk of 6-monthadverse clinical outcomes.