Usefulness of early plasma S-100B protein and Neuron-Specific Enolase measurements to identify cerebrovascular etiology of out-of-hospital cardiac arrest
| Autor: | Sybille Merceron, Jean-Paul Mira, Michel Arnaout, Alain Cariou, Fabrice Daviaud, Frédéric Pène, Camille Chenevier-Gobeaux, Nicolas Deye, Nathalie Marin, Nicolas Mongardon, Stéphane Legriel, Guillaume Geri |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Subarachnoid hemorrhage Enolase S100 Calcium Binding Protein beta Subunit 030204 cardiovascular system & hematology Emergency Nursing Gastroenterology S 100b protein 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Internal medicine medicine Humans Respiratory system Stroke Aged business.industry Case-control study 030208 emergency & critical care medicine Middle Aged medicine.disease Prognosis Early Diagnosis ROC Curve Case-Control Studies Phosphopyruvate Hydratase Emergency Medicine Etiology Biomarker (medicine) Female France Cardiology and Cardiovascular Medicine business Biomarkers Out-of-Hospital Cardiac Arrest |
| Zdroj: | Resuscitation. 130 |
| ISSN: | 1873-1570 |
| Popis: | While S-100B protein and Neuron-Specific Enolase (NSE) dosages have been extensively investigated for neurological prognostication after cardiac arrest (CA), there is no data about their ability to detect a cerebrovascular cause of CA. We assessed the utility of plasma S-100B protein and NSE measurements for early diagnosis of primary neurological cause in resuscitated CA patients.Case control study based on two prospectively acquired CA databases. Patients with a primary cerebrovascular etiology were compared with randomly selected CA of non-neurological cause. S-100B protein and NSE were measured at ICU admission in all patients.CA was due to a cerebrovascular etiology in 18 patients (subarachnoid hemorrhage, n = 15; ischemic stroke, n = 3), with an ICU mortality of 100%. Comparative group was constituted with 66 patients (cardiac etiology n = 45, respiratory etiology n = 21), with an ICU mortality of 71%. Admission S-100B protein concentration was 2.0 [0.63-7.15] μg/L in the cerebrovascular group and 0.45 [0.24-1.95] in the non-cerebrovascular group (p 0.001). In contrast, NSE concentration was similar in cerebrovascular and non-cerebrovascular etiologies (35 [25-103] μg/L vs. 27 [19-47] respectively, p = 0.16). Area under ROC curves for S-100B protein and NSE to predict cerebrovascular cause of CA was 0.75 [95% CI: 0.64-0.87] and 0.61 [95% CI: 0.45-0.76], respectively.Even if S-100B protein dosage performs slightly better than NSE, early dosages of these biomarkers are poorly predictive of a cerebrovascular etiology of CA. Our results suggest that early measurement of brain biomarkers should not be recommended to tailor the imaging strategy employed to investigate the CA cause. |
| Databáze: | OpenAIRE |
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