Association of Taurine with In-Hospital Mortality in Patients after Out-of-Hospital Cardiac Arrest: Results from the Prospective, Observational COMMUNICATE Study

Abstract

Background: Studies have suggested that taurine may have neuro- and cardio-protective functions, but there is little research looking at taurine levels in patients after out-of-hospital cardiac arrest (OHCA). Our aim was to evaluate the association of taurine with mortality and neurological deficits in a well-defined cohort of OHCA patients. Methods: We prospectively measured serum taurine concentration in OHCA patients upon admission to the intensive care unit (ICU) of the University Hospital Basel (Switzerland). We analyzed the association of taurine levels and in-hospital mortality (primary endpoint). We further evaluated neurological outcomes assessed by the cerebral performance category scale. We calculated logistic regression analyses and report odds ratios (OR) and 95% confidence intervals (CI). We calculated different predefined multivariable regression models including demographic variables, comorbidities, initial vital signs, initial blood markers and resuscitation measures. We assessed discrimination by means of area under the receiver operating curve (ROC). Results: Of 240 included patients, 130 (54.2%) survived until hospital discharge and 110 (45.8%) had a favorable neurological outcome. Taurine levels were significantly associated with higher in-hospital mortality (adjusted OR 4.12 (95%CI 1.22 to 13.91), p = 0.02). In addition, a significant association between taurine concentration and a poor neurological outcome was observed (adjusted OR of 3.71 (95%CI 1.13 to 12.25), p = 0.03). Area under the curve (AUC) suggested only low discrimination for both endpoints (0.57 and 0.57, respectively). Conclusion: Admission taurine levels are associated with mortality and neurological outcomes in OHCA patients and may help in the risk assessment of this vulnerable population. Further studies are needed to assess whether therapeutic modulation of taurine may improve clinical outcomes after cardiac arrest.

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

“…Multiple methods have been examined to predict neurological recovery and overall survival early after resuscitation from OHCA. Elevated serum levels of several biomarkers, including taurine 211 and neuron-specific enolase, 212–214 correlate with poorer outcomes.…”

Comparison of different clinical risk scores to predict long-term survival and neurological outcome in adults after cardiac arrest: results from a prospective cohort study

“…The COMMUNICATE/PRO-PHETIC study investigates the outcomes of cardiac arrest patients and the psychosocial stress of their relatives. The details of the study conductance have been published previously [29,[36][37][38][39][40][41]. Informed consent was either obtained from the patient or the relatives, depending on the decision-making capability of the index patient.…”

Intra‐ischemic hypothermia cardioprotection involves modulation of PTEN/Akt/ERK signaling and fatty acid oxidation

“…In the present study, we report for the first time that intra-ischemic TH was associated with attenuated cardiac taurine release during reperfusion, indicating decreased osmotic stress. This finding is of potential clinical relevance, as it was recently reported that elevated serum taurine on admission to the hospital after out-of-hospital cardiac arrest was associated with increased in-hospital mortality and poor neurological outcome (Herzog et al, 2020). Therefore, modulation of cardiac taurine release by TH should be carefully considered in future studies assessing taurine as a biomarker for cardiac arrest and ischemic heart pathologies.…”

“…Considering the observation that TH modulates the response of Akt to I/R, we next investigated whether TH treatment affects cardiac release of metabolites related to Akt signaling and cardiac arrest outcomes—taurine and lactate (Donnino et al, 2014 ; Herzog et al, 2020 ; Schaffer et al, 2014 ). Coronary perfusate was collected before ischemia and after 10 min of reperfusion (R10) for assessment of taurine and lactate release (Figure 4a–d ).…”