Molecular biomarkers in prediction of neurological outcomes after sudden cardiac arrest

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BACKGROUND

Many tools were developed to predict neurological outcomes after sudden circulatory arrest. However, none has absolute predictive value. Neuron-specific enolase (NSE) and S100 protein are of practical importance.

OBJECTIVE

To analyze the most perspective biomarkers used in predicting neurological outcomes after sudden circulatory arrest, their advantages and disadvantages, sensitivity and specificity.

MATERIAL AND METHODS

We reviewed the eLibrary, PubMed and Scopus databases for the period 2010—2022 and selected 57 articles.

RESULTS

S100B protein is useful for earlier prediction of the outcome after circulatory arrest compared to NSE. As for unfavorable neurological outcome, NSE ≤17 µg/l excludes adverse outcomes with negative predictive value of 92%. Serum S100 concentration within 3.56—16.6 ng/l is an indicator of unfavorable neurological outcomes. Serum GFAP concentration of 0.08 μg/l in 36—60 hours after restoration of spontaneous circulation can be considered as a predictor of adverse neurological outcomes.

CONCLUSION

Modern biomarkers are in demand and promising in intensive care. Glial (glial fibrillar acidic protein, neurofilament light chain protein) and neuronal (serum tau protein, neutrophil gelatinase-associated lipocalin and others) markers are being studied. Algorithms for predicting the neurological outcomes after sudden circulatory arrest based on qualitative and quantitative analysis of markers of ischemic neuronal damage are being actively developed. Despite long-term history of research of certain markers (S100 protein and NSE), the list of potential biomarkers is updated every year.

Keywords:

biomarkers

neurological outcome

cardiopulmonary resuscitation

post-resuscitation care

Authors:

Starostin D.O.

Negovsky Research Institute of Intensive Care

ORCID: 0000-0002-5069-6080

Shkerdina M.I.

Sechenov First Moscow State Medical University

ORCID: 0000-0002-3749-2227

Kuzovlev A.N.

Negovsky Research Institute of Intensive Care

SPIN RSCI: 8648-3771
Scopus AuthorID: 35201397900
ResearcherID: F-6462-2017
ORCID: 0000-0002-5930-0118

Grechko A.V.

Negovsky Research Institute of Intensive Care

ORCID: 0000-0003-3318-796X

Received:

16.02.2023

Accepted:

17.07.2023

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