Acute cardiac care & resuscitation
Neurofilament Light Chain and Glial Fibrillary Acidic Protein as early prognostic biomarkers after out-of-hospital cardiac arrest
Authors' conclusion
Serum NfL and GFAP may be strong biomarkers of poor functional outcome after OHCA from an early timepoint.
Study context
- Population
- Comatose out-of-hospital cardiac arrest (OHCA) patients treated with targeted temperature management (33 ± 1 °C)
- Participants
- 82 patients
- Comparison
- Serum NfL and Glial Fibrillary Acidic Protein (GFAP) vs Neuron Specific Enolase (NSE) for neuroprognostication
- Primary endpoint
- Prognostic performance of serum NfL and GFAP for poor functional outcome (CPC 3-5)
- Follow-up
- 6 months
Methodological detailssub-study, Serum samples at 24, 48 and 72 h after reaching target temperature; GFAP analysed at 48 and 72 h
- Sub-study
- Serum samples at 24, 48 and 72 h after reaching target temperature; GFAP analysed at 48 and 72 h
Primary result
As reported in the abstract
Serum NfL and GFAP, poor (CPC 3-5) vs good (CPC 1-2) outcome at 6 months
- NfL 24 h, poor vs good outcome (both p < 0.001)
- 1371.5 (462.0; 2125.1) vs. 24.8 (14.0; 61.6)
- GFAP 48 h, poor vs good outcome (both p < 0.001)
- 1285.3 (843.9; 2236.7) vs. 361.2 (200.4; 665.6)
- NfL 24 h AUROC for poor outcome
- 0.95 (95% CI: 0.91-1.00)
- GFAP 48 h AUROC for poor outcome
- 0.88 (95% CI: 0.81-0.96)
- NfL and GFAP both predicted outcome better than NSE at 48 h
- both p < 0.01
- At 72 h NfL but not GFAP outperformed NSE
- p = 0.01
Further findings
Prognostic performance vs NSE · 48 h and 72 h
- NfL and GFAP both predicted outcome better than NSE at 48 h
- both p < 0.01
- At 72 h NfL but not GFAP outperformed NSE
- P = 0.01
Original publication
Neurofilament Light Chain and Glial Fibrillary Acidic Protein as early prognostic biomarkers after out-of-hospital cardiac arrest. Resuscitation. Published 29 September 2023. doi:10.
Summarised from the published abstract; every number is checked against it