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The Importance Of Measuring Cerebrospinal Fluid Biomarkers In Cardiac Arrest Survivors (P1.101)

Objective: Investigate the levels of various cerebrospinal fluid biomarkers related to neuronal damage, inflammation and amyloid metabolism.
Background: Cardiac arrest survivors have a poor outcome and it is early in the process important to discern patients which have a poor prognosis. CSF can give a reflection of the biochemical status of the brain. It has already been shown that Neurofilament protein (NFL) is a reliable marker of brain damage in this patient group.
Design/Methods: Cerebrospinal fluid levels of NFL, total Tau, hyperphosphorylated Tau and YKL-40 were measured in 21 patients approximately 14 days after a cardiac arrest and in 21 age matched neurologically healthy controls. Patients were followed one year. The biomarker levels were compared between patients with a poor/good outcome according to Glasgow Outcome Scale (GOS), activity of daily living (ADL) and mini mental state examination (MMSE). Pair-wise comparison of group means were done using the Mann-Whitney test. A p-value of < 0.05 was considered statistical significant.
Results: The patients surviving a cardiac arrest had a very pronounced increase in the CSF levels of Neurofilament proteins, T-Tau and YKL-40 as compared with healthy controls. NFL and t-Tau were significantly higher in patients with poor outcome according to all outcome measures. Patients with a poor outcome according to GOS and ADL had higher levels of YKL-40.
Conclusions: Biomarkers reflecting neuronal damage and inflammation were significantly increased in patients surving at least two weeks after a cardiac arrest. The levels were more marked in the patients with a poor outcome. This fact could be used as a way to determine the size of brain damage as a complement to the clinical assessment, radiological imaging and EEG in the difficult task to determine the prognosis in this patient group. Tau and YKL-40 proved to be equivalent to NFL and further research should emphasize in detecting them in serum, which would increase the clinical use. Disclosure: Dr. Rosen has nothing to disclose. Dr. Rosen has nothing to disclose. Dr. Andreasson has nothing to disclose. Dr. Bremell has nothing to disclose. Dr. Bremler has nothing to disclose. Dr. Hagberg has received personal compensation for activities with Baxter and Meda as an advisory board member, and Astella as a speaker. Dr. Hagberg has received personal compensation in an editorial capacity for Scandinavian Journal Infectious Diseases. Dr. Rosengren has nothing to disclose. Dr. Blennow has nothing to disclose. Dr. Zetterberg has nothing to disclose.