Neurofilament light as an outcome predictor after cardiac arrest: a post hoc analysis of the COMACARE trial
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ORIGINAL
Neurofilament light as an outcome predictor after cardiac arrest: a post hoc analysis of the COMACARE trial Lauri Wihersaari1, Nicholas J. Ashton2,3,4,5, Matti Reinikainen1, Pekka Jakkula6, Ville Pettilä6, Johanna Hästbacka6, Marjaana Tiainen7, Pekka Loisa8, Hans Friberg9, Tobias Cronberg10, Kaj Blennow2,11, Henrik Zetterberg2,11,12,13, Markus B. Skrifvars14* and the COMACARE STUDY GROUP © 2020 The Author(s)
Abstract 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 ( PaCO2), arterial oxygen tension (PaO2), 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
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