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=> true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Ángel Pérula de Torres, Jesús González-Lama, Celia Jiménez García, Rosa Sánchez Montero, Faustino Rider Garrido, Yolanda Ortega López, Diego Pajares Conde, Miguel Ramírez Baena, Ignacio Párraga Martínez, Esperanza Romero-Rodríguez" "autores" => array:11 [ 0 => array:2 [ "nombre" => "Luis Ángel" "apellidos" => "Pérula de Torres" ] 1 => array:2 [ "nombre" => "Jesús" "apellidos" => "González-Lama" ] 2 => array:2 [ "nombre" => "Celia" "apellidos" => "Jiménez García" ] 3 => array:2 [ "nombre" => "Rosa" "apellidos" => "Sánchez Montero" ] 4 => array:2 [ "nombre" => "Faustino" "apellidos" => "Rider Garrido" ] 5 => array:2 [ "nombre" => "Yolanda" "apellidos" => "Ortega López" ] 6 => array:2 [ "nombre" => "Diego" "apellidos" => "Pajares Conde" ] 7 => array:2 [ "nombre" => "Miguel" "apellidos" => "Ramírez Baena" ] 8 => array:2 [ "nombre" => "Ignacio" "apellidos" => "Párraga Martínez" ] 9 => array:2 [ "nombre" => "Esperanza" 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array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 8 => array:3 [ "nombre" => "Enrique" "apellidos" => "Santas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 9 => array:3 [ "nombre" => "Gema" "apellidos" => "Miñana" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] ] ] 10 => array:3 [ "nombre" => "Luis" "apellidos" => "Manzano" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff0035" ] ] ] 11 => array:3 [ "nombre" => "Antoni" "apellidos" => "Bayés-Genís" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">h</span>" "identificador" => "aff0040" ] ] ] 12 => array:3 [ "nombre" => "Julio" "apellidos" => "Núñez" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] ] ] ] "afiliaciones" => array:8 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital de Valme, Sevilla, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Cardiología, Hospital Clínico Universitario, Universitat de València, INCLIVA, Valencia, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital de Manises, Valencia, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Servicio de Cardiología, Hospital de Manises, Valencia, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "CIBER Cardiovascular, Madrid, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Departamento de Medicina y Especialidades Médicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, IRYCIS, Madrid, Spain" "etiqueta" => "g" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Spain" "etiqueta" => "h" "identificador" => "aff0040" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Comparación entre CA125 y NT-proBNP para valorar la congestión en insuficiencia cardíaca aguda" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 811 "Ancho" => 2175 "Tamanyo" => 94032 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Relationship of CA125 and NT-proBNP with the presence of pleural effusion. CA125: carbohydrate antigen 125; NT-proBNP: N-terminal prohormone of brain natriuretic peptide.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Patients with acute heart failure (AHF) usually have symptoms and signs attributable to congestion.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> However, the correct evaluation of the severity of congestion remains a great clinical challenge, especially since the precision of symptoms, signs, and ancillary examinations such as the chest X-ray is very limited.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Various scientific societies currently recommend a multi-pronged approach to congestion, recommending the use of multiple parameters, including clinical assessment, biomarkers, and imaging, according to availability and experience.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">It has been postulated that the levels of carbohydrate antigen 125 (CA125), a glycoprotein synthesised by mesothelial cells, increase in response to higher hydrostatic venous pressures and/or inflammatory stimuli in AHF patients.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a> Its increase in the serum of AHF patients has been related to the traditional parameters of clinical congestion.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> It is also a prognostic marker and can serve as a useful tool to guide the intensity of diuretic treatment.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,7–10</span></a> The evidence supporting the relationship between NT-proBNP and congestion severity, although generally accepted, is more debatable.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The objective of this study was to compare the relationship between CA125 and NT-proBNP with the main parameters of clinical congestion (peripheral oedema), radiological (pleural effusion) and ultrasound (dilation of the inferior vena cava) in patients hospitalized for AHF.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Methods</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Study population</span><p id="par0025" class="elsevierStylePara elsevierViewall">This is a multicenter prospective observational study that included 191 patients hospitalized for AHF in three centres (Hospital Clínico de Valencia, Hospital de Manises, and Hospital General de Castellón), from September to November 2019. AHF was diagnosed by cardiologists and internists with experience in heart failure according to the definition proposed by the guidelines in force at the time of patient inclusion.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> All patients had symptoms (rest or minimal effort dyspnoea) and/or signs attributable to congestion on admission. In all cases the patients were treated with intravenous furosemide. At 24–48 h after admission, the patients underwent a physical examination, blood tests (including determination of CA125 and NT-proBNP), chest X-ray, two-dimensional transthoracic echocardiogram, and an ultrasound assessment of the inferior vena cava (IVC) diameter. During hospitalisation, patients received individualised follow-up and therapeutic management according to routine clinical practice recommendations. All included patients gave written informed consent, and the study protocol was approved by the corresponding clinical research ethics committee and complied with the ethical principles of the 1975 Declaration of Helsinki.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Echocardiographic evaluation</span><p id="par0030" class="elsevierStylePara elsevierViewall">It was performed by a transthoracic echocardiography using commercially available systems during hospitalization (24–48 h after admission) coinciding with the evaluation of the biomarkers. Two-dimensional and Doppler measurements were performed in accordance with international recommendations using standard views and techniques.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Biomarker evaluation</span><p id="par0035" class="elsevierStylePara elsevierViewall">Plasma values of NT-proBNP and CA125 were determined by commercially available immunoassays (Elecsys® NT-proBNP assay, Roche Diagnostics; and Elecsys® CA125 II assay, Roche Diagnostics).</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical analysis</span><p id="par0040" class="elsevierStylePara elsevierViewall">Continuous variables were shown as mean ± standard deviation (SD) or median [interquartile range (IQR)], depending on its distribution. The categorical variables were expressed as percentages. The association between the CA125 (U/mL) and NT-proBNP (pg/mL) values with the different congestion parameters were analysed using the Wilcoxon rank-sum tests (Mann–Whitney) and were correlated using the Spearman correlation test. The factors independently associated with the presence of pleural effusion and peripheral oedema were evaluated using a logistic regression analysis. A multiple linear regression analysis was used for the evaluation of factors associated with the IVC diameter. All the variables included in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> were evaluated as possible covariates to evaluate. The functional form of the continuous variables was assessed using fractional polynomials and appropriate transformations were carried out. After the initial selection of covariates, a <span class="elsevierStyleItalic">step-down</span> sequential simplification process was carried out. In the final multivariate models, all those variables with plausible biological effect or potential confounding effect were included regardless of the p value. The final covariates included in the baseline multivariate models were for a) peripheral oedema: age, sex, diabetes mellitus, atrial fibrillation, and heart rate; b) pleural effusion: age, sex, arterial hypertension, and atrial fibrillation; c) IVC: age, sex, diabetes mellitus, heart rate and haemoglobin. The additional discriminative capacity of both biomarkers (CA125 and NT-proBNP) to predict the presence of oedema and pleural effusion was evaluated using the area under the ROC (<span class="elsevierStyleItalic">receiver operating characteristic</span>) curve. The contribution of the covariates to the variability of the inferior vena cava diameter in the multiple linear regression model was assessed by the coefficient of determination (R<span class="elsevierStyleSup">2</span>). A two-tailed p-value of <0.05 was considered statistically significant for all analyses. All analyses were performed with STATA 15.1 (StataCorp, 2017, Stata Statistical Software: Release 15; StataCorp, LLC, College Station, TX).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Baseline characteristics</span><p id="par0045" class="elsevierStylePara elsevierViewall">Mean ages ± SD of the sample was 73.4 ± 12 years, 79 (41.4%) were women, 127 (66.5%) had left ventricular ejection fraction ≥50%, 98 (48.7%) had atrial fibrillation (AF), and 65 (34%) had ischemic heart disease. Mean ± SD of systolic blood pressure, creatinine and haemoglobin were 144 ± 33 mmHg, 1.26 ± 0.53 mg/dL, and 12.6 ± 2.2 g/dL, respectively. The patients with peripheral oedema and pleural effusion were 126 (67.5%) and 102 (53.4%), respectively. The median (25–75% percentile) of CA125, NT-proBNP and IVC diameter was 58 (22.7–129) U/mL, 3,985 (1,905–9,775) pg/mL, and 21 (17–25) mm, respectively. The complete baseline characteristics of the study population are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">CA125 and NT-proBNP: relationship with the presence of peripheral oedema</span><p id="par0050" class="elsevierStylePara elsevierViewall">Patients with peripheral oedema showed higher plasma CA125 values (62 vs. 32.8 U/mL, p < 0.005), while no significant differences were observed with the NT-proBNP values (4,324 vs. 3,781 pg/mL, p = 0.209). In the multivariate analysis, CA125 was linearly, positively, and significantly associated with the presence of peripheral oedema on admission (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a). The addition of CA125 to the baseline multivariate model was associated with an increase in the limit of significance of the model's discriminative capacity (area under the ROC curve: 0.72 vs. 0.66; p = 0.051). On the other hand, NT-proBNP, evaluated continuously, was not significantly associated with the presence of peripheral oedema (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>b). The inclusion of NT-proBNP did not improve the discriminative capacity of the baseline model either (area under the ROC curve: 0.67 vs. 0.66, p = 0.534). <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the covariates and risk estimation of the multivariate model.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">CA125 and NT-proBNP: relationship with the presence of pleural effusion</span><p id="par0055" class="elsevierStylePara elsevierViewall">In the bivariate analysis, the presence of pleural effusion was associated with higher levels of CA125 and NT-proBNP [73.9 vs. 32 U/mL (p < 0.0001) and 6.175 vs. 3,149 pg/mL (p < 0.0002), respectively]. In the multivariate analysis, NT-proBNP and CA125 were positively and independently associated with the risk of having pleural effusion, positively and linearly for both biomarkers (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>a and b, respectively). The inclusion of CA125 increased the discriminative capacity of the baseline model (area under the ROC curve: 0.74 vs. 0.67; p = 0.020). However, this increase was not significant when NT-proBNP was included in the baseline model (area under the ROC curve: 0.70 vs. 0.67; p = 0.165). <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the covariates and risk estimates of the final multivariate model.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">CA125 and NT-proBNP: relationship with the inferior vena cava diameter</span><p id="par0060" class="elsevierStylePara elsevierViewall">IVC dilatation (≥21 mm) was associated with higher CA125 and NT-proBNP values (73.45 vs. 33 U/mL, p < 0.001; and 5,622 vs. 2,723 pg/mL, p = 0.002, respectively). In addition, this parameter was correlated in the bivariate analysis with CA125 and NT-proBNP (Spearman's rho = 0.3987, p < 0.001 and 0.2823, p = 0.001, respectively). In multiple linear regression analysis, age, heart rate, haemoglobin, NT-proBNP, and CA125 were independent predictor variables. <a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>a shows the positive and non-linear association between CA125 values and the IVC diameter. A strongly positive relationship in patients with values lower than 50 U/mL and a plateau for higher values. For NT-proBNP there was a linear and independent relationship (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>b). The multivariate analysis revealed that the predictor with the highest power predicting the variability of the IVC diameter was CA125 (R<span class="elsevierStyleSup">2</span> = 48.3%), followed by haemoglobin (R<span class="elsevierStyleSup">2</span> = 15.9%), age (R<span class="elsevierStyleSup">2</span> = 10.4%), HR (R<span class="elsevierStyleSup">2</span> = 10.4%) and NT-proBNP (R<span class="elsevierStyleSup">2</span> = 8.7%). <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the details of the final multivariate model.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0065" class="elsevierStylePara elsevierViewall">In this study of patients with AHF and congestive symptomatology, serum CA125 values were significantly associated with clinical (peripheral oedema), radiological (pleural effusion), and ultrasound (IVC diameter) congestion parameters. In contrast, NT-proBNP values were only significantly associated with the presence of pleural effusion and IVC diameter. Furthermore, the magnitude of the association between CA125 levels and the three evaluated congestion parameters showed superiority compared to the associations observed for NT-proBNP.</p><p id="par0070" class="elsevierStylePara elsevierViewall">These results corroborate what was observed in previous studies and make CA125 a useful parameter, superior to NT-proBNP for assessing congestion in AHF patients.</p><p id="par0075" class="elsevierStylePara elsevierViewall">It is postulated that, in patients with HF, CA125 is synthesized by serous epithelial cells in response to congestion or inflammatory stimuli.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a> Numerous publications in recent years indicate that plasma concentrations of this glycoprotein could be useful as a biomarker in AHF.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5–10</span></a> From a clinical perspective, the CA125 provides information on the degree of congestion present in HF.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5–10</span></a> For example, positive associations of this biomarker have been described with the presence of serous effusions, peripheral oedema, inferior vena cava pressure and pulmonary wedge pressure.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5–10,13</span></a> Interestingly, very recent results position this biomarker as a useful clinical tool for the identification of patients with predominantly right HF.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> In this same sense, Yilmaz et al., observed high levels of CA125 in patients with right ventricular dysfunction.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15,16</span></a> A recent study in a cohort of 2,949 patients with AHF showed that the main factors associated with CA125 values in this population were the clinical parameters of congestion and the severity of tricuspid regurgitation.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> In contrast, this relationship was not observed for NT-proBNP.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> In this way, these and the previous results support the value of CA125 as a useful marker in the identification of patients with predominantly right HF and its consequences. Interestingly, the utility of CA125 as a surrogate marker not only of extravascular congestion, but also of intravascular congestion is suggested in the present study, given that CA125 was the main predictor of IVC dilatation, explaining almost half of the variability in the model. Similar to these results, Josa-Laorden et al., in a recent study including 85 patients with AHF, also described a positive association between elevated CA125 values, greater IVC diameter and absence of collapse.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">Regarding natriuretic peptides (NP) and their relation to heart failure, the main mechanism by which they are released is the stress to which cardiomyocytes are subjected due to volume and/or pressure overload.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> Currently, NPs are the most widely used biomarkers for the diagnosis and prognosis of HF.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> However, its utility as a surrogate congestion parameter is less clear.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a> The highest NP values are observed in patients with HF due to left ventricular (LV) systolic dysfunction,<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14,18,19</span></a> however, the contribution of right heart dysfunction does not seem to translate into an additional increase in NP in patients with elevated values already due to predominantly left HF, as right heart involvement only results in much smaller elevations of natriuretic peptides.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14,20</span></a> A recent study showed that the most important determinants of NT-proBNP values in AHF were, in order of importance, age, renal function and the degree of LV systolic dysfunction.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> Interestingly, neither the clinical parameters of congestion nor surrogate echocardiographic parameters of right dysfunction were associated with higher values of NT-proBNP.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> These findings are consistent with the results of the present study, where CA125 was strongly and positively related to congestion parameters, with NT-proBNP having a weaker relationship.</p><p id="par0085" class="elsevierStylePara elsevierViewall">The practical implications of both biomarkers are important. Both have been shown to be independent predictors of adverse events after an episode of AHF, so their combined use seems reasonable,<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5–10,18,19</span></a> especially if both provide complementary pathophysiological information, CA125 as a marker of congestion and NT-proBNP as a functional impact marker of the left ventricle.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">In addition, CA125 has been shown to be useful for monitoring the clinical course after decompensation and to guide the diuretic therapy.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9,10,21</span></a> The CHANCE-HF randomized clinical trial showed that a CA125-guided diuretic strategy (intensive diuretic therapy in patients with higher CA125 values) reduced the risk of death/readmission due to heart failure at one year of follow-up in 380 patients after a recent episode by AHF.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> It was recently evaluated with the same approach in the IMPROVE-HF clinical trial, which included 160 patients with AHF and renal dysfunction at onset (mean estimated glomerular filtration rate of 33.7 ± 11.3 mL/min/1.73 m<span class="elsevierStyleSup">2</span>) and the CA125-guided strategy resulted in an improvement in renal dysfunction parameters at 72 h.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> On the contrary, much of the available evidence does not support the use of natriuretic peptides to guide treatment in HF patients.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18,22</span></a></p><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Limitations</span><p id="par0095" class="elsevierStylePara elsevierViewall">This study has several limitations that deserve to be mentioned. First, this is an observational study with a limited sample size, so the results shown here may be subject to significant selection and confounding biases. Our results are not applicable to patients with chronic HF as we included patients with AHF. Echocardiographic variables of left ventricular diastolic dysfunction (left ventricular wall thickness, transmitral flow pattern, E/e' ratio, or left atrial size) or right ventricular dysfunction [Tricuspid Annular Plane Systolic Excursion (TAPSE), pulmonary artery systolic pressure, among others]. This study population was characterised by a prevalence of preserved LVEF, so these results need to be confirmed in populations with a different phenotypic profile. Finally, other congestion parameters, such as the presence of crackles, jugular venous distention, orthopnoea, or paroxysmal nocturnal dyspnoea, were not included in the present analysis.</p></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclusions</span><p id="par0100" class="elsevierStylePara elsevierViewall">In patients with AHF evaluated in the first 24–48 h, CA125 levels are strongly and positively associated with congestion parameters. NT-proBNP levels showed a weaker association.</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Funding</span><p id="par0105" class="elsevierStylePara elsevierViewall">This study was carried out thanks to resources partly provided by <span class="elsevierStyleGrantSponsor" id="gs0005">CIBER</span> Cardiovascular (<span class="elsevierStyleGrantNumber" refid="gs0005">16/11/00420</span> and <span class="elsevierStyleGrantNumber" refid="gs0005">16/11/00403</span>).</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflict of interests</span><p id="par0110" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1526946" "titulo" => "Abstract" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods and results" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1384383" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1526947" "titulo" => "Resumen" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Métodos y resultados" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1384384" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0010" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0015" "titulo" => "Methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Study population" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Echocardiographic evaluation" ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Biomarker evaluation" ] 3 => array:2 [ "identificador" => "sec0035" "titulo" => "Statistical analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0040" "titulo" => "Results" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0045" "titulo" => "Baseline characteristics" ] 1 => array:2 [ "identificador" => "sec0050" "titulo" => "CA125 and NT-proBNP: relationship with the presence of peripheral oedema" ] 2 => array:2 [ "identificador" => "sec0055" "titulo" => "CA125 and NT-proBNP: relationship with the presence of pleural effusion" ] 3 => array:2 [ "identificador" => "sec0060" "titulo" => "CA125 and NT-proBNP: relationship with the inferior vena cava diameter" ] ] ] 7 => array:3 [ "identificador" => "sec0065" "titulo" => "Discussion" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0070" "titulo" => "Limitations" ] ] ] 8 => array:2 [ "identificador" => "sec0075" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0080" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0085" "titulo" => "Conflict of interests" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-03-01" "fechaAceptado" => "2020-05-23" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1384383" "palabras" => array:4 [ 0 => "CA125" 1 => "NT-proBNP" 2 => "Acute heart failure" 3 => "Congestion" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1384384" "palabras" => array:4 [ 0 => "CA125" 1 => "NT-proBNP" 2 => "Insuficiencia cardiaca aguda" 3 => "Congestión" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Carbohydrate antigen 125 (CA125) and B-type natriuretic peptides are surrogate markers of congestion in patients with acute heart failure (AHF). The aim of the study was to assess the association between CA125 and NT-proBNP and congestion parameters in patients with AHF.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods and results</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Prospective multicentre observational study that included 191 patients hospitalised for AHF. We recorded the presence of pleural effusion, peripheral oedema and inferior vena cava (IVC) diameter during the first 24–48 h after admission and evaluated their independent association with CA125 concentrations and the amino-terminal fraction of pro-B-type natriuretic peptide (NT-proBNP). The mean age was 73.4 ± 12 years, 79 (41.4%) were women, and 127 (66.5%) had left ventricular ejection fraction ≥50%. The median of CA125, NT-proBNP and IVC diameter was 58 (22.7–129) U/mL, 3,985 (1,905–9,775) pg/mL and 21 (17–25) mm, respectively. Multivariate analysis showed that CA125 was positively and independently associated with the presence of peripheral oedema, pleural effusion and elevated IVC levels. NT-proBNP was associated with pleural effusion and IVC diameter but not with oedema. The addition of CA125 increased the discriminatory capacity of the baseline model to identify peripheral oedema and pleural effusion, but not NT-proBNP. The most important predictor of ICV dilation was CA125 (R<span class="elsevierStyleSup">2</span> = 48.3%).</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conclusion</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">In patients with AHF, serum CA125 levels are associated more significantly than NT-proBNP with a state of congestion.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods and results" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Antecedentes</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">El antígeno carbohidrato 125 (CA125) y los péptidos natriuréticos tipo B son marcadores subrogados de congestión en pacientes con insuficiencia cardíaca aguda (ICA). El objetivo del estudio fue valorar la asociación entre CA125 y NT-proBNP y parámetros de congestión en pacientes con ICA.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Métodos y resultados</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional prospectivo multicéntrico, que incluyó a 191 pacientes hospitalizados por ICA. Se registró la presencia de derrame pleural, edema periférico y diámetro de vena cava inferior (V<span class="elsevierStyleSmallCaps">C</span>I) durante las primeras 24–48 horas tras el ingreso y se evaluó su asociación independiente con las concentraciones de CA125 y la fracción amino-terminal del péptido natriurético tipo B (NT-proBNP). La edad media fue de 73,4 ± 12 años, 79 (41,4%) eran mujeres y 127 (66,5%) tenían fracción de eyección ventricular izquierda ≥50%. La mediana de CA125, NT-proBNP y diámetro VCI fue de 58 (22,7–129) U/mL, 3.985 (1.905–9.775) pg/mL y 21 (17–25) mm, respectivamente. El análisis multivariante mostró que el CA125 se asoció positiva e independientemente con presencia de edema periférico, derrame pleural y valores elevados de VCI. El NT-proBNP se relacionó con el derrame pleural y el diámetro de VCI, pero no con el edema. La adición del CA125 incrementó la capacidad discriminativa del modelo basal para identificar edema periférico y derrame pleural, no así el NT-proBNP. El predictor más importante para la dilatación de la VCI fue el CA125 (R<span class="elsevierStyleSup">2</span> = 48,3%).</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusión</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">En pacientes con ICA, los niveles séricos de CA125 se asocian de forma más significativa que los de NT-proBNP con el estado de congestión.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Métodos y resultados" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as: Llàcer P, Gallardo MÁ, Palau P, Moreno MC, Castillo C, Fernández C, et al. Comparación entre CA125 y NT-proBNP para valorar la congestión en insuficiencia cardíaca aguda. Med Clin (Barc). 2021;156:589–594.</p>" ] ] "multimedia" => array:6 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 819 "Ancho" => 2175 "Tamanyo" => 92630 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Relationship of CA125 and NT-proBNP with the presence of peripheral oedema. CA125: carbohydrate antigen 125; NT-proBNP: N-terminal prohormone of brain natriuretic peptide.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 811 "Ancho" => 2175 "Tamanyo" => 94032 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Relationship of CA125 and NT-proBNP with the presence of pleural effusion. CA125: carbohydrate antigen 125; NT-proBNP: N-terminal prohormone of brain natriuretic peptide.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 810 "Ancho" => 2175 "Tamanyo" => 76468 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Relationship of CA125 and NT-proBNP with the inferior vena cava diameter. CA125: carbohydrate antigen 125; NT-proBNP: N-terminal prohormone of brain natriuretic peptide.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">CA125: carbohydrate antigen 125; NT-proBNP: N-terminal prohormone of brain natriuretic peptide; IVC: inferior vena cava; LVEF: left ventricular ejection fraction; ACEI, angiotensin converting enzyme inhibitor; ARBs, angiotensin II receptor blockers; ARNI: angiotensin receptor-neprilysin inhibitor; DBP, diastolic blood pressure; SBP, systolic blood pressure; SD, standard deviation.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total (n = 191) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Demographic data</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Age, years, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">73.2 (2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sex, female, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79 (41.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Clinical history</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Arterial hypertension, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">159 (83.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">102 (53.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ischemic heart disease, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65 (34) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Atrial fibrillation, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">98 (48.69) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Clinical and laboratory parameters</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>SBP, mmHg, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">144 (33) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DBP, mmHg, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80 (19.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Heart rate, bpm, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">95.98 (4.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Packed cell volume %, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.59 (6.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Haemoglobin, g/dL, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.6 (2.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Creatinine mg/dL, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.26 (0.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Potassium, mEq/L, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.36 (0.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sodium, mEq/L, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">138.54 (4.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CA125, U/mL, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58 (22.7−129) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NT-proBNP, pg/mL, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.985 (1.905.5−9775) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Echocardiography</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IVC diameter, mm, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>LVEF ≥50%, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">127 (66.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Treatment</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IV diuretics, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">109 (72.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>ACEI/ARBs/ARNI, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63 (34.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Spironolactone, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">102 (67.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Beta-blockers, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">81 (42.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2624467.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Baseline characteristics.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">CA125: carbohydrate antigen 125; NT-proBNP: N-terminal prohormone of brain natriuretic peptide; HBP: high blood pressure; DM: diabetes mellitus.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Predictors of peripheral oedema</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Variable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">OR (95% CI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">P value \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Age, per 10-year increase \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.08 (0.81−1.45) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.598 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.95 (0.48–1.87) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.874 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.57 (0.81−3.06) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.181 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Atrial fibrillation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.33 (1.18−4.60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.015 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Heart rate, per 10 bpm increase \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.86 (0.75−0.99) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.038 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NT-proBNP, per 1,000 pg/mL increase \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.02 (0.99−1.06) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.385 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CA125, per 10 U/mL increase \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.07 (1.02−1.13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.005 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Predictors of pleural effusion</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Variable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">OR (95% CI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">P value \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Age, per 10-year increase \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.20 (0.90−1.60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.222 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.03 (0.53−1.98) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.927 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HBP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.45 (0.18−1.13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.088 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Atrial fibrillation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.14 (1.13−4.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.019 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NT-proBNP, per 100 pg/mL increase \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.05 (1.01−1.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.016 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CA125, per 10 U/mL increase \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.07 (1.03−1.12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2624469.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Factors independently associated with the presence of pleural effusion and peripheral oedema: multivariate logistic regression model.</p>" ] ] 5 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">CA125: carbohydrate antigen 125; NT-proBNP: N-terminal prohormone of brain natriuretic peptide; DM diabetes mellitus.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Coefficient® (95% CI) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age, per 10-year increase \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.88 (−1.47 to −0.29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.004 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.08 (−1.31 to 1.48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.906 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">DM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.21 (−0.17 to 2.58) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.084 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Heart rate, per 10-year increase \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.39 (−0.67 to −0.12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.005 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Haemoglobin, per 1 g/dL increase \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.28 (0.06–0.62) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NT-proBNP, per 100 pg/mL increase \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.11 (0.02–0.19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.016 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CA125<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−1.73 (−2.44 to −1.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2624468.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">CA125 included as a polynomial: –0.5.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Factors associated with the inferior cava diameter; multiple linear regression model.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:22 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quality of care and outcomes in acute decompensated heart failure: the ADHERE registry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.W. 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Original article
Comparison between CA125 and NT-proBNP for evaluating congestion in acute heart failure
Comparación entre CA125 y NT-proBNP para valorar la congestión en insuficiencia cardíaca aguda
Pau Llàcera,
, Mari Ángeles Gallardob, Patricia Palauc, Mari Carmen Morenod, Carla Castilloe, Cristina Fernándezd, Rafael de la Espriellac, Anna Mollarc, Enrique Santasc, Gema Miñanac,f, Luis Manzanoa,g, Antoni Bayés-Genísh, Julio Núñezc,f
Corresponding author
a Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, Madrid, Spain
b Servicio de Medicina Interna, Hospital de Valme, Sevilla, Spain
c Servicio de Cardiología, Hospital Clínico Universitario, Universitat de València, INCLIVA, Valencia, Spain
d Servicio de Medicina Interna, Hospital de Manises, Valencia, Spain
e Servicio de Cardiología, Hospital de Manises, Valencia, Spain
f CIBER Cardiovascular, Madrid, Spain
g Departamento de Medicina y Especialidades Médicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, IRYCIS, Madrid, Spain
h Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Spain