GFAp and tau protein as predictors of neurological outcome after out-of-hospital cardiac arrest: A post hoc analysis of the COMACARE trial

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COMACARE Study Groups , Humaloja , J J , Lähde , M , Ashton , N J , Reinikainen , M , Hästbacka , J , Jakkula , P , Friberg , H , Cronberg , T , Pettilä , V , Blennow , K , Zetterberg , H & Skrifvars , M 2022 , ' GFAp and tau protein as predictors of neurological outcome after out-of-hospital cardiac arrest: A post hoc analysis of the COMACARE trial ' , Resuscitation , vol. 170 , pp. 141-149 . https://doi.org/10.1016/j.resuscitation.2021.11.033

Title: GFAp and tau protein as predictors of neurological outcome after out-of-hospital cardiac arrest: A post hoc analysis of the COMACARE trial
Author: COMACARE Study Groups; Humaloja, Jaana J; Lähde, Marika; Ashton, Nicholas J.; Reinikainen, Matti; Hästbacka, Johanna; Jakkula, Pekka; Friberg, Hans; Cronberg, Tobias; Pettilä, Ville; Blennow, Kaj; Zetterberg, Henrik; Skrifvars, Markus
Contributor organization: HUS Emergency Medicine and Services
HYKS erva
Päijät-Häme Welfare Consortium
Clinicum
HUS Perioperative, Intensive Care and Pain Medicine
Department of Diagnostics and Therapeutics
Anestesiologian yksikkö
Date: 2022-01
Language: eng
Number of pages: 9
Belongs to series: Resuscitation
ISSN: 0300-9572
DOI: https://doi.org/10.1016/j.resuscitation.2021.11.033
URI: http://hdl.handle.net/10138/342114
Abstract: Aim: To determine the ability of serum glial fibrillary acidic protein (GFAp) and tau protein to predict neurological outcome after out-of-hospital cardiac arrest (OHCA). Methods: We measured plasma concentrations of GFAp and tau of patients included in the previously published COMACARE trial (NCT02698917) on intensive care unit admission and at 24, 48, and 72 h after OHCA, and compared them to neuron specific enolase (NSE). NSE concentrations were determined already during the original trial. We defined unfavourable outcome as a cerebral performance category (CPC) score of 3-5 six months after OHCA. We determined the prognostic accuracy of GFAp and tau using the receiver operating characteristic curve and area under the curve (AUROC). Results: Overall, 39/112 (35%) patients had unfavourable outcomes. Over time, both markers were evidently higher in the unfavourable outcome group (p < 0.001). At 48 h, the median (interquartile range) GFAp concentration was 1514 (886-4995) in the unfavourable versus 238 (135-463) pg/ ml in the favourable outcome group (p < 0.001). The corresponding tau concentrations were 99.6 (14.5-352) and 3.0 (2.2-4.8) pg/ml (p < 0.001). AUROCs at 48 and 72 h were 0.91 (95% confidence interval 0.85-0.97) and 0.91 (0.85-0.96) for GFAp and 0.93 (0.86-0.99) and 0.95 (0.89-1.00) for tau. Corresponding AUROCs for NSE were 0.86 (0.79-0.94) and 0.90 (0.82-0.97). The difference between the prognostic accuracies of GFAp or tau and NSE were not statistically significant. Conclusions: At 48 and 72 h, serum both GFAp and tau demonstrated excellent accuracy in predicting outcomes after OHCA but were not superior to NSE. Clinical trial registration: NCT02698917 (https://www.clinicaltrials.gov/ct2/show/NCT02698917).
Subject: 3112 Neurosciences
3124 Neurology and psychiatry
3126 Surgery, anesthesiology, intensive care, radiology
Out-of-hospital cardiac arrest
Biomarkers
Tau protein
Glial fibrillary acidic protein
Neurological outcome prognostication
FIBRILLARY ACIDIC PROTEIN
EUROPEAN-RESUSCITATION-COUNCIL
AMERICAN-HEART-ASSOCIATION
CARE MEDICINE GUIDELINES
BRAIN-INJURY
COMATOSE PATIENTS
SERUM-LEVELS
BIOMARKERS
HYPOTHERMIA
DIFFUSION
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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