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Carbohydrate antigen 125 (CA125) following acute myocardial infarction: effects of empagliflozin and association with heart failure readouts in the EMMY trial

Sci Rep. 2025 Dec 23. doi: 10.1038/s41598-025-32913-y. Online ahead of print.

ABSTRACT

Carbohydrate antigen 125 (CA125) is increasingly recognized as a biomarker in heart failure (HF). However, its response to sodium-glucose co-transporter 2 inhibitors (SGLT2i) after acute myocardial infarction (AMI) remains insufficiently explored. In this study, CA125 levels were measured from plasma samples collected in the EMMY trial, and robust linear mixed-effects models (R-LMEMs) were applied to assess the effects of empagliflozin on CA125 levels, their changes over a 26-week period, and their associations with established HF biomarkers. Our analysis showed that empagliflozin had no statistically significant effect on log-transformed CA125 levels. CA125 exhibited minor fluctuations at 6 weeks before declining at 26 weeks to a level below baseline, which had been measured shortly after AMI. Log-transformed CA125 was significantly associated with log-transformed N-terminal pro-B-type natriuretic peptide (NT-proBNP) and multiple echocardiographic parameters, including left ventricular ejection fraction (LVEF), end-diastolic and end-systolic dimensions, and volumes (LVEDD, LVEDV, LVESD, LVESV), and the ratio of early diastolic transmitral inflow velocity to early diastolic mitral annular velocity (E/e’). Notably, CA125’s associations with NT-proBNP and E/e’ were modified by empagliflozin. In conclusion, although CA125 showed significant associations with established HF biomarkers, it did not exhibit a parallel response to empagliflozin after AMI.

PMID:41430429 | DOI:10.1038/s41598-025-32913-y

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