Neuron-Specific Enolase Predicts Poor Outcome After Cardiac Arrest and Targeted Temperature Management: A Multicenter Study on 1,053 Patients

Streitberger, Kaspar Josche; Leithner, Christoph; Wattenberg, M.; Tonner, Peter H.; Haßlacher, Julia; Joannidis, Michael; Pellis, Tommaso; Luca, Elena; Födisch, M.; Krannich, Alexander; Ploner, Christoph J.; Storm, Christian

doi:10.1097/ccm.0000000000002335

Cited by 97 publications

(78 citation statements)

References 27 publications

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“…Besides, S-100B, an acidic protein with a calcium binding motif produced by astroglial cells in the brain, is a predictive marker for outcome of patients after cardiac arrest [8]. Neuron specific enolase (NSE), another a neural protein primarily produced by neurons and is leaked into the extracellular space after severe injury, is also a useful predictor of outcome in PCAS patients [9]. Lipocalin, might predict the neurological outcomes of PCAS patients, and its predictive value was equivalent to that of NSE [10].…”

Section: Introductionmentioning

confidence: 99%

High plasma levels of pro-inflammatory factors interleukin-17 and interleukin-23 are associated with poor outcome of cardiac-arrest patients: a single center experience

Zhuang

Chen

Zhou

et al. 2020

BMC Cardiovasc Disord

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Background: Systemic inflammation is an important feature of post-cardiac arrest syndrome (PCAS). This study was designed to determine whether the plasma concentrations of some circulating pro-inflammatory cytokines , IL-22, IL-23 and IL-33) are of value in predicting the outcome of patients after return of spontaneous circulation (ROSC) during the post-cardiac arrest period. Methods: This was a prospective observational clinical study. In total, 21 patients (survivors, n = 10; non-survivors, n = 11) who experienced cardiac arrest and successful ROSC with expected survival of at least 7 days were consecutively enrolled from January 2016 to December 2017. Of the 21 enrolled patients, ten survived were designated "survivors". The other eleven patients died between 2 days and 1 months post ROSC. Venous blood was drawn at three time-points: baseline (< 1 h post ROSC), 2 days post ROSC and 7 days post ROSC. Plasma IL-8, IL-22, IL-23 and IL-33 were determined using commercial enzyme-linked immunosorbent assays. Results: Plasma creatinine levels, but aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, were elevated in non-survivors compared with survivors. Plasma levels of IL-17, IL-22, IL-23 and IL-33 of the 21 total patients did not change at 2 or 7 days post ROSC compared to baseline. In survivors, the plasma levels of IL-17 and IL-23 at 2 or 7 days post ROSC were lower than baseline. In non-survivors, plasma levels of IL-17 increased compared with baseline. Receiver operating characteristic curve analysis showed that the plasma levels of IL-17 and IL-23 at 2 or 7 days post ROSC were able to predict the mortality of PCAS patients, and positively correlated with Acute Physiology and Chronic Health Evaluation (APACHE)-II score and time to ROSC.Conclusion: These results provide the first evidence that the elevated plasma IL-17 and IL-23 levels are associated with poor outcome in PCAS patients. The role of IL-17/IL-23 axis post ROSC is worth paying attention to in PCAS patients.Trial registration: Clinicaltrial.gov NCT02297776, 2014-11-21.

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Section: Introductionmentioning

confidence: 99%

High plasma levels of pro-inflammatory factors interleukin-17 and interleukin-23 are associated with poor outcome of cardiac-arrest patients: a single center experience

Zhuang

Chen

Zhou

et al. 2020

BMC Cardiovasc Disord

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“…In the case of HIE, since CSF‐NSE was increased when neurons turned degenerative and necrotic, and the serum NSE (s‐NSE) level was elevated due to BBB disruption, both s‐NSE and CSF‐NSE could be deemed as the biomarkers for indicating the severity and prognosis of neuron damages (Noaman et al., ; Varsami et al., ). For instance, when the cut‐off value of NSE was set as ≥45.4 μg/L, the sensitivity and specificity of s‐NSE for diagnosing medium and severe HIE were, respectively, 79% and 70% (Streitberger et al., ). However, applying NSE for diagnosing HIE was still unsatisfactory, for that the increased NSE could also be found within other disorders, including neonatal hyperbilirubinemia, infectious brain injury, and brain injury caused by congenital metabolic diseases (Gazzolo et al., ; Yao, Zhang, Ai, Liu, & Huang, ).…”

Section: Discussionmentioning

confidence: 99%

Combined prediction of miR‐210 and miR‐374a for severity and prognosis of hypoxic–ischemic encephalopathy

et al. 2017

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Background and AimHypoxic–ischemic encephalopathy (HIE) is a disorder featured by hypoxic and ischemic damages during the perinatal period and its high mortality (i.e., 15%–20%) could be partly attributed to late diagnosis. Therefore, miR‐210 and miR‐374a were investigated to find if they could improve the diagnostic values of S100B protein and neuron‐specific enolase (NSE) for HIE.MethodsAltogether 167 HIE newborns and 82 healthy newborns were recruited, and their blood were sampled for determining the levels of biomarkers. Specifically, S100B protein and NSE levels were detected based on the enzyme‐linked immunosorbent assay (ELISA) kit, while the expressions of miR‐210 and miR‐374a were quantified by quantitative reverse transcription–polymerase chain reaction (qRT‐PCR). Moreover, the receiver operating characteristic (ROC) curves were established to assess the diagnostic values of the above biomarkers for HIE. Finally, the correlation analysis between miR‐210/miR‐374 and Neonatal Behavioral Neurological Assessment (NBNA) scoring or Gesell intellectual development were also conducted.ResultsThe levels of miR‐210, miR‐374a, S100B protein, and NSE were significantly distinct between HIE patients and healthy newborns (p < .05). Besides, miR‐210 (r s = .573), miR‐374a (r s = .651), NSE level (r s = −.622), and S100B level (r s = −.55) were all, respectively, correlated with NBNA scoring with statistical significance (p < .05). Furthermore, it was revealed that the combined diagnosis of miR‐210, miR‐374a, S100B protein, and NSE could obtain the highest accuracy regarding pairs of mild HIE versus moderate HIE (AUC = 0.898), moderate HIE versus severe HIE (AUC = 0.922), mild HIE versus severe HIE (AUC = 0.996), and HIE versus control (AUC = 0.960). More than that, the four molecules were also remarkably associated with Gesell intellectual development (p < .05).ConclusionMiR‐210 and miR‐374a could help to elevate the diagnostic value and prognostic prediction of S100B protein and NSE for HIE.

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“…10 A similar European study prospectively analysed NSE serum concentrations in >1000 patients who were cooled to 33 C after cardiac arrest. 11 They found that high concentrations reliably predicted poor outcome at critical care discharge. 11 While biomarker use is uncommon in current UK practice, interpretation should be in combination with other forms of testing.…”

Section: Biomarkersmentioning

confidence: 99%

“…11 They found that high concentrations reliably predicted poor outcome at critical care discharge. 11 While biomarker use is uncommon in current UK practice, interpretation should be in combination with other forms of testing.…”

Section: Biomarkersmentioning

confidence: 99%

Prognostication of patients after cardiopulmonary resuscitation

Jackson

Mockridge

2018

BJA Education

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Learning objectives By reading this article, you should be able to: Assess the place of neurological prognostication in the overall critical care management of a patient after cardiac arrest. Describe the outcome scores in common usage for post-cardiac arrest patients. Explain the value and limitation of clinical, electrophysiological, biochemical, and imaging signs in neurological prognostication.

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Neuron-Specific Enolase Predicts Poor Outcome After Cardiac Arrest and Targeted Temperature Management: A Multicenter Study on 1,053 Patients

Cited by 97 publications

References 27 publications

High plasma levels of pro-inflammatory factors interleukin-17 and interleukin-23 are associated with poor outcome of cardiac-arrest patients: a single center experience

High plasma levels of pro-inflammatory factors interleukin-17 and interleukin-23 are associated with poor outcome of cardiac-arrest patients: a single center experience

Combined prediction of miR‐210 and miR‐374a for severity and prognosis of hypoxic–ischemic encephalopathy

Prognostication of patients after cardiopulmonary resuscitation

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