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Cancer antigen-125 and risk of atrial fibrillation: a systematic review and meta-analysis
  1. Angel Cheung1,
  2. Mengqi Gong2,
  3. Roberto Bellanti3,
  4. Sadeq Ali-Hasan-Al-Saegh4,
  5. Guangping Li2,
  6. Eulàlia Roig5,
  7. Julio Núñez6,7,
  8. Thomas D Stamos8,
  9. Mehmet Birhan Yilmaz9,
  10. Kaya Hakki9,
  11. William K K Wu10,11,
  12. Sunny Hei Wong11,12,
  13. Wing Tak Wong13,
  14. George Bazoukis14,
  15. Konstantinos Lampropoulos14,
  16. Lah Ah Tse15,
  17. Jichao Zhao16,
  18. Gregory Y H Lip17,18,
  19. Adrian Baranchuk19,
  20. Martin C S Wong20,
  21. Tong Liu2,
  22. Gary Tse11,12
  23. International Health Informatics Study (IHIS) Network
  1. 1 Department of Biomedical Engineering, Brown University, Providence, Rhode Island, USA
  2. 2 Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
  3. 3 Department of Medicine, Cambridge University Hospital NHS Trust, Cambridge, UK
  4. 4 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  5. 5 Cardiology Department, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Biomèdica Sant Pau and Universitat Autònoma, Barcelona, Spain
  6. 6 Cardiology Department, Departamento de Medicina, Hospital Clínico Universitario, Universitat de València, Valencia, Spain
  7. 7 CIBER in Cardiovascular Diseases (CIBERCV), Madrid, Spain
  8. 8 Department of Cardiology, University of Illinois at Chicago, Chicago, Illinois, USA
  9. 9 Department of Cardiology, Cumhuriyet University Medical School, Sivas, Turkey
  10. 10 Department of Anaesthesia and Intensive Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
  11. 11 Faculty of Medicine, Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, China
  12. 12 Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
  13. 13 School of Life Sciences, Chinese University of Hong Kong, Hong Kong, China
  14. 14 Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, Athens, Greece
  15. 15 Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
  16. 16 Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
  17. 17 Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
  18. 18 Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
  19. 19 Division of Cardiology, Kingston General Hospital, Queen’s University, Kingston, Ontario, Canada
  20. 20 JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
  1. Correspondence to Dr Gary Tse, Department of Medicine and Therapeutics and Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China; tseg{at}cuhk.edu.hk

Abstract

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
  • arrhythmias

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Footnotes

  • 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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