Neurofilament light compared to neuron-specific enolase as a predictor of unfavourable outcome after out-of-hospital cardiac arrest

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Wihersaari , L , Reinikainen , M , Furlan , R , Mandelli , A , Vaahersalo , J , Kurola , J , Tiainen , M , Pettilä , V , Bendel , S , Varpula , T , Latini , R , Ristagno , G & Skrifvars , M B 2022 , ' Neurofilament light compared to neuron-specific enolase as a predictor of unfavourable outcome after out-of-hospital cardiac arrest ' , Resuscitation , vol. 174 , pp. 1-8 . https://doi.org/10.1016/j.resuscitation.2022.02.024

Title: Neurofilament light compared to neuron-specific enolase as a predictor of unfavourable outcome after out-of-hospital cardiac arrest
Author: Wihersaari, L.; Reinikainen, M.; Furlan, R.; Mandelli, A.; Vaahersalo, J.; Kurola, J.; Tiainen, M.; Pettilä, V.; Bendel, S.; Varpula, T.; Latini, R.; Ristagno, G.; Skrifvars, M. B.
Contributor organization: HUS Perioperative, Intensive Care and Pain Medicine
Anestesiologian yksikkö
HUS Neurocenter
Neurologian yksikkö
Department of Neurosciences
Department of Diagnostics and Therapeutics
Clinicum
University of Helsinki
HUS Emergency Medicine and Services
Date: 2022-05
Language: eng
Number of pages: 8
Belongs to series: Resuscitation
ISSN: 0300-9572
DOI: https://doi.org/10.1016/j.resuscitation.2022.02.024
URI: http://hdl.handle.net/10138/344348
Abstract: Aim: We compared the prognostic abilities of neurofilament light (NfL) and neuron-specific enolase (NSE) in patients resuscitated from out-ofhospital cardiac arrest (OHCA) of various aetiologies. Methods: We analysed frozen blood samples obtained at 24 and 48 hours from OHCA patients treated in 21 Finnish intensive care units in 2010 and 2011. We defined unfavourable outcome as Cerebral Performance Category (CPC) 3-5 at 12 months after OHCA. We evaluated the prognostic ability of the biomarkers by calculating the area under the receiver operating characteristic curves (AUROCs [95% confidence intervals]) and compared these with a bootstrap method. Results: Out of 248 adult patients, 12-month outcome was unfavourable in 120 (48.4%). The median (interquartile range) NfL concentrations for patients with unfavourable and those with favourable outcome, respectively, were 689 (146-1804) pg/mL vs. 31 (17-61) pg/mL at 24 h and 1162 (147-4360) pg/mL vs. 36 (21-87) pg/mL at 48 h, p < 0.001 for both. The corresponding NSE concentrations were 13.3 (7.2-27.3) mg/L vs. 8.5 (5.8- 13.2) mg/L at 24 h and 20.4 (8.1-56.6) mg/L vs. 8.2 (5.9-12.1) mg/L at 48 h, p < 0.001 for both. The AUROCs to predict an unfavourable outcome were 0.90 (0.86-0.94) for NfL vs. 0.65 (0.58-0.72) for NSE at 24 h, p < 0.001 and 0.88 (0.83-0.93) for NfL and 0.73 (0.66-0.81) for NSE at 48 h, p < 0.001. Conclusion: Compared to NSE, NfL demonstrated superior accuracy in predicting long-term unfavourable outcome after OHCA.
Subject: Neurofilament light (NfL)
Neuron-Specific Enolase (NSE)
Out-of-hospital cardiac arrest
OHCA
Resuscitation
Cardiac arrest
Neurological outcome
Biomarkers
TARGETED TEMPERATURE MANAGEMENT
DAMAGE
BLOOD
NSE
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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