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RESEARCH PRODUCT

Prognostic effect of carbohydrate antigen 125-guided therapy in patients recently discharged for acute heart failure (CHANCE-HF). Study design.

Julio NúñezMerlos PilarFácila LorenzoLlàcer PauBosch Maria JoséVicente Bertomeu-martínezGarcía-blas SergioMontagud VicentePedrosa ValleMendizábal AndreaCordero AlbertoMiñana GemaSanchis JuanVicente Bertomeu-gonzalezMorell Salvador

subject

AdultMalemedicine.medical_specialtyRandomizationTime FactorsRisk AssessmentAntigenCause of DeathRisk of mortalityMedicineHumansIn patientSingle-Blind MethodProspective StudiesIntensive care medicineAgedHeart Failurebusiness.industryStandard treatmentDisease ManagementCardiovascular AgentsGeneral MedicineMiddle Agedmedicine.diseasePrognosisPatient DischargeClinical trialSurvival RateSpainHeart failureCA-125 AntigenAcute DiseaseFemalebusinessCarbohydrate antigenBiomarkersFollow-Up Studies

description

Abstract Introduction and objectives Morbidity and mortality after admission for acute heart failure remain prohibitively high. In that setting, plasma levels of antigen carbohydrate 125 have shown to correlate with the severity of fluid overload and the risk of mortality and readmission. Preliminary data suggests a potential role of antigen carbohydrate 125 to guide therapy. The objective of this study is to evaluate the prognostic effect of an antigen carbohydrate 125-guided management strategy vs standard therapy in patients recently discharged for acute heart failure. Methods This is a multicenter, randomized, single-blind, efficacy trial study of patients recently discharged from acute heart failure ( 35 U/ml. A randomization scheme was used to allocate participants (in a 1:1 ratio) to receive therapy guided by antigen carbohydrate 125 (aiming to keep normal values) or standard treatment. Mainly, antigen carbohydrate 125-guided therapy is focused on the frequency of monitoring and titration of decongestive therapies and statins. As of December 10, 2013, there were 383 patients enrolled. The primary outcome was the composite of 1-year all-cause mortality or rehospitalization for acute heart failure. Analysis was planned to be intention-to-treat. Conclusions Discovering novel therapeutic strategies or finding better ways of optimizing established treatments have become a health care priority in heart failure. This study will add important knowledge about the potential of antigen carbohydrate 125 as a management tool for monitoring and titration of therapies where optimal utilization has not been well defined, such as diuretics and statins. Trial registration: ClinicalTrials.gov number: NCT02008110.

10.1016/j.rec.2014.03.018https://pubmed.ncbi.nlm.nih.gov/25623430