Background Cancer antigen-125 (Ca-125) is traditionally recognised as a tumour marker and its role in cardiovascular diseases has been studied only in recent years. Whether Ca-125 is elevated in patients with atrial fibrillation (AF) and its levels predict the risk of AF remains controversial. Therefore, we conducted a systematic review and meta-analysis of the association between Ca-125 levels and AF.
Methods PubMed and EMBASE databases were searched until 1 June 2017 for studies that evaluated the association between Ca-125 and AF. Inclusion criteria included studies that compare Ca-125 in patients with and without AF, or those reporting HRs/ORs for risk of AF stratified by Ca-125 levels.
Results A total of 39 entries were retrieved from the databases, of which 10 studies were included in the final meta-analysis. Ca-125 was significantly higher in patients with AF compared with those in sinus rhythm (mean difference=16 U/mL, 95% CI 2 to 30 U/mL, P<0.05; I2: 98%). Ca-125 significantly increased the risk of AF (HR: 1.39, 95% CI 1.06 to 1.82, P<0.05; I2: 84%).
Conclusion Ca-125 was significantly higher in patients with AF than in those in sinus rhythm, and high Ca-125 is predictive of AF occurrence. However, the high heterogeneity observed means there is an uncertainty in the relationship between Ca-125 and AF, which needs to be confirmed by larger prospective studies.
- atrial fibrillation
- risk stratification
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Contributors AC: screening of articles, data extraction, drafting of manuscript. MG: critical revision of manuscript, conducted quality analysis. GT: conceived the study, screening of articles, data extraction, drafted the manuscript, critical revision of manuscript. JN, TDS, MBY, KH: provided additional data from their original publications for meta-analysis, critical revision of manuscript. All other authors contributed to critical revision of manuscript.
Funding GT and SHW are supported by the Croucher Foundation of Hong Kong. This work was supported by a research grant (Number: 81570298) from the National Natural Science Foundation of China to TL.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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