PMID- 32852582
OWN - NLM
STAT- MEDLINE
DCOM- 20210531
LR  - 20210531
IS  - 1432-1238 (Electronic)
IS  - 0342-4642 (Print)
IS  - 0342-4642 (Linking)
VI  - 47
IP  - 1
DP  - 2021 Jan
TI  - Neurofilament light as an outcome predictor after cardiac arrest: a post hoc 
      analysis of the COMACARE trial.
PG  - 39-48
LID - 10.1007/s00134-020-06218-9 [doi]
AB  - PURPOSE: Neurofilament light (NfL) is a biomarker reflecting neurodegeneration 
      and acute neuronal injury, and an increase is found following hypoxic brain 
      damage. We assessed the ability of plasma NfL to predict outcome in comatose 
      patients after out-of-hospital cardiac arrest (OHCA). We also compared plasma NfL 
      concentrations between patients treated with two different targets of arterial 
      carbon dioxide tension (PaCO(2)), arterial oxygen tension (PaO(2)), and mean 
      arterial pressure (MAP). METHODS: We measured NfL concentrations in plasma 
      obtained at intensive care unit admission and at 24, 48, and 72 h after OHCA. We 
      assessed neurological outcome at 6 months and defined a good outcome as Cerebral 
      Performance Category (CPC) 1-2 and poor outcome as CPC 3-5. RESULTS: Six-month 
      outcome was good in 73/112 (65%) patients. Forty-eight hours after OHCA, the 
      median NfL concentration was 19 (interquartile range [IQR] 11-31) pg/ml in 
      patients with good outcome and 2343 (587-5829) pg/ml in those with poor outcome, 
      p < 0.001. NfL predicted poor outcome with an area under the receiver operating 
      characteristic curve (AUROC) of 0.98 (95% confidence interval [CI] 0.97-1.00) at 
      24 h, 0.98 (0.97-1.00) at 48 h, and 0.98 (0.95-1.00) at 72 h. NfL concentrations 
      were lower in the higher MAP (80-100 mmHg) group than in the lower MAP 
      (65-75 mmHg) group at 48 h (median, 23 vs. 43 pg/ml, p = 0.04). PaCO(2) and 
      PaO(2) targets did not associate with NfL levels. CONCLUSIONS: NfL demonstrated 
      excellent prognostic accuracy after OHCA. Higher MAP was associated with lower 
      NfL concentrations.
FAU - Wihersaari, Lauri
AU  - Wihersaari L
AD  - Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, 
      Kuopio, Finland.
FAU - Ashton, Nicholas J
AU  - Ashton NJ
AD  - Department of Psychiatry and Neurochemistry, Institute of Neuroscience and 
      Physiology, The Sahlgrenska Academy at the University of Gothenburg, Molndal, 
      Sweden.
AD  - Wallenberg Centre for Molecular and Translational Medicine, University of 
      Gothenburg, Gothenburg, Sweden.
AD  - Institute of Psychiatry, Psychology and Neuroscience, King's College London, 
      London, UK.
AD  - NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit 
      for Dementia at South London and Maudsley NHS Foundation, London, UK.
FAU - Reinikainen, Matti
AU  - Reinikainen M
AD  - Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, 
      Kuopio, Finland.
FAU - Jakkula, Pekka
AU  - Jakkula P
AD  - Department of Anaesthesiology, Intensive Care and Pain Medicine, University of 
      Helsinki and Helsinki University Hospital, Helsinki, Finland.
FAU - Pettila, Ville
AU  - Pettila V
AD  - Department of Anaesthesiology, Intensive Care and Pain Medicine, University of 
      Helsinki and Helsinki University Hospital, Helsinki, Finland.
FAU - Hastbacka, Johanna
AU  - Hastbacka J
AD  - Department of Anaesthesiology, Intensive Care and Pain Medicine, University of 
      Helsinki and Helsinki University Hospital, Helsinki, Finland.
FAU - Tiainen, Marjaana
AU  - Tiainen M
AD  - Department of Neurology, University of Helsinki and Helsinki University Hospital, 
      Helsinki, Finland.
FAU - Loisa, Pekka
AU  - Loisa P
AD  - Department of Intensive Care, Paijat-Hame Central Hospital, Lahti, Finland.
FAU - Friberg, Hans
AU  - Friberg H
AD  - Department of Clinical Sciences Lund, Anesthesiology and Intensive Care, Lund 
      University, Skane University Hospital, Malmo, Sweden.
FAU - Cronberg, Tobias
AU  - Cronberg T
AD  - Department of Clinical Sciences Lund, Neurology, Lund University, Skane 
      University Hospital, Lund, Sweden.
FAU - Blennow, Kaj
AU  - Blennow K
AD  - Department of Psychiatry and Neurochemistry, Institute of Neuroscience and 
      Physiology, The Sahlgrenska Academy at the University of Gothenburg, Molndal, 
      Sweden.
AD  - Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Molndal, 
      Sweden.
FAU - Zetterberg, Henrik
AU  - Zetterberg H
AD  - Department of Psychiatry and Neurochemistry, Institute of Neuroscience and 
      Physiology, The Sahlgrenska Academy at the University of Gothenburg, Molndal, 
      Sweden.
AD  - Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Molndal, 
      Sweden.
AD  - UK Dementia Research Institute at UCL, London, UK.
AD  - Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.
FAU - Skrifvars, Markus B
AU  - Skrifvars MB
AUID- ORCID: 0000-0002-0341-0262
AD  - Department of Emergency Care and Services, Helsinki University Hospital and 
      University of Helsinki, Helsinki, Finland. markus.skrifvars@hus.fi.
CN  - COMACARE STUDY GROUP
LA  - eng
GR  - TYH2018227/Helsingin ja Uudenmaan Sairaanhoitopiiri/
GR  - 2018, 2019/Stiftelsen Dorothea Olivia, Karl Walter och Jarl Walter Perklens 
      Minne/
GR  - 2018, 2019/Medicinska Understodsforeningen Liv och Halsa/
GR  - #2017-00915/Swedish Reserach Council/
GR  - #AF-742881/The Swedish Alzheimer Foundation/
GR  - #FO2017-0243/Hjarnfonden/
GR  - #2018-02532/Swedish Research Council/
GR  - #ALFGBG-720931/Swedish State Support for Clinical Research/
GR  - (#201809-2016862/Alzheimer Drug Discovery Foundation/
GR  - #ALFGBG-715986/the Swedish state under the agreement between the Swedish 
      government and the County Councils, the ALF-agreement/
GR  - JPND2019-466-236/European Union Joint Program for Neurodegenerative Disorders/
GR  - #681712/ERC_/European Research Council/International
PT  - Journal Article
DEP - 20200827
PL  - United States
TA  - Intensive Care Med
JT  - Intensive care medicine
JID - 7704851
SB  - IM
CIN - Intensive Care Med. 2021 Jan;47(1):77-79. PMID: 33169216
MH  - Arterial Pressure
MH  - Blood Gas Analysis
MH  - Coma
MH  - Humans
MH  - *Intermediate Filaments
MH  - *Out-of-Hospital Cardiac Arrest/therapy
PMC - PMC7782453
OTO - NOTNLM
OT  - Biomarkers
OT  - Cardiac arrest
OT  - Neurofilament light (NfL)
OT  - Prognostication
COIS- Markus Skrifvars reports speakers' fees and travel grants from BARD Medical 
      (Ireland) and a research grant from GE Healthcare. Kaj Blennow has served as a 
      consultant, at advisory boards, or at data monitoring committees for Abcam, Axon, 
      Biogen, Julius Clinical, Lilly, MagQu, Novartis, Roche Diagnostics, and Siemens 
      Healthineers, and is a co-founder of Brain Biomarker Solutions in Gothenburg AB 
      (BBS), which is a part of the GU Ventures Incubator Program. Henrik Zetterberg 
      has served at scientific advisory boards for Denali, Roche Diagnostics, Wave, 
      Samumed and CogRx, has given lectures in symposia sponsored by Fujirebio, 
      Alzecure and Biogen, and is a co-founder of Brain Biomarker Solutions in 
      Gothenburg AB (BBS), which is a part of the GU Ventures Incubator Program.
FIR - Laru-Sompa, Raili
IR  - Laru-Sompa R
FIR - Pulkkinen, Anni
IR  - Pulkkinen A
FIR - Reilama, Mikko
IR  - Reilama M
FIR - Tolmunen, Sinikka
IR  - Tolmunen S
FIR - Backlund, Minna
IR  - Backlund M
FIR - Heinonen, Jonna
IR  - Heinonen J
FIR - Hastbacka, Johanna
IR  - Hastbacka J
FIR - Jakkula, Pekka
IR  - Jakkula P
FIR - Lundbom, Nina
IR  - Lundbom N
FIR - Norrgard, Marcus
IR  - Norrgard M
FIR - Okkonen, Marjatta
IR  - Okkonen M
FIR - Pettila, Ville
IR  - Pettila V
FIR - Skrifvars, Markus B
IR  - Skrifvars MB
FIR - Suhonen, Tarja
IR  - Suhonen T
FIR - Tiainen, Marjaana
IR  - Tiainen M
FIR - Tikka, Tuukka
IR  - Tikka T
FIR - Timonen, Marjut
IR  - Timonen M
FIR - Toppila, Jussi
IR  - Toppila J
FIR - Valkonen, Miia
IR  - Valkonen M
FIR - Wilkman, Erika
IR  - Wilkman E
FIR - Hult, Teemu
IR  - Hult T
FIR - Oksanen, Tuomas
IR  - Oksanen T
FIR - Bendel, Stepani
IR  - Bendel S
FIR - Halonen, Elina
IR  - Halonen E
FIR - Rahikainen, Sari
IR  - Rahikainen S
FIR - Rissanen, Saija
IR  - Rissanen S
FIR - Vaskelainen, Eija
IR  - Vaskelainen E
FIR - Eiserbeck, Tanja
IR  - Eiserbeck T
FIR - Heino, Sirkku
IR  - Heino S
FIR - Jyrkonen, Helena
IR  - Jyrkonen H
FIR - Reinikainen, Matti
IR  - Reinikainen M
FIR - Rasanen, Johanna
IR  - Rasanen J
FIR - Surakka, Tero
IR  - Surakka T
FIR - Koskue, Talvikki
IR  - Koskue T
FIR - Kujala, Petteri
IR  - Kujala P
FIR - Loisa, Pekka
IR  - Loisa P
FIR - Lahde, Marika
IR  - Lahde M
FIR - Kalliomaki, Jari
IR  - Kalliomaki J
FIR - Karlsson, Sari
IR  - Karlsson S
FIR - Kukkurainen, Atte
IR  - Kukkurainen A
FIR - Varila, Simo
IR  - Varila S
EDAT- 2020/08/28 06:00
MHDA- 2021/06/01 06:00
PMCR- 2020/08/27
CRDT- 2020/08/28 06:00
PHST- 2020/05/12 00:00 [received]
PHST- 2020/08/14 00:00 [accepted]
PHST- 2020/08/28 06:00 [pubmed]
PHST- 2021/06/01 06:00 [medline]
PHST- 2020/08/28 06:00 [entrez]
PHST- 2020/08/27 00:00 [pmc-release]
AID - 10.1007/s00134-020-06218-9 [pii]
AID - 6218 [pii]
AID - 10.1007/s00134-020-06218-9 [doi]
PST - ppublish
SO  - Intensive Care Med. 2021 Jan;47(1):39-48. doi: 10.1007/s00134-020-06218-9. Epub 
      2020 Aug 27.