Relationship between markers of inflammation and hemodynamic stress and death in patients with out-of-hospital cardiac arrest

Abstract Biomarkers that reflect hemodynamic stress, inflammation, extracellular matrix remodeling, angiogenesis, and endothelial dysfunction may improve risk stratification and add valuable pathobiological insight in patients with out-of-hospital cardiac arrest (OHCA). In total, 120 patients with O...

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Autores principales:	Thomas A. Zelniker, Ziya Kaya, Eva Gamerdinger, Sebastian Spaich, Jan Stiepak, Evangelos Giannitsis, Hugo A. Katus, Michael R. Preusch
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/239a66f8605e48ec9d3aa7dba288ce58
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spelling	oai:doaj.org-article:239a66f8605e48ec9d3aa7dba288ce582021-12-02T17:02:05ZRelationship between markers of inflammation and hemodynamic stress and death in patients with out-of-hospital cardiac arrest10.1038/s41598-021-88474-32045-2322https://doaj.org/article/239a66f8605e48ec9d3aa7dba288ce582021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88474-3https://doaj.org/toc/2045-2322Abstract Biomarkers that reflect hemodynamic stress, inflammation, extracellular matrix remodeling, angiogenesis, and endothelial dysfunction may improve risk stratification and add valuable pathobiological insight in patients with out-of-hospital cardiac arrest (OHCA). In total, 120 patients with OHCA who survived at least 48 h after return of spontaneous circulation were consecutively included in the present analysis. Concentrations of 30 biomarkers were measured simultaneously using a multi-panel biomarker assay. Cox regression models were adjusted for age, sex, estimated glomerular filtration rate, lactate concentration, bystander resuscitation, initial cardiac rhythm, and type of targeted temperature management. Overall, 57 patients (47.5%) had a favorable neurological outcome (Cerebral Performance Category ≤ 2) at 30 days, while palliative care was initiated in 49 patients (40.8%), and 52 patients (43.3%) died. After correction for multiple testing with Bonferroni-Holm, 8 biomarkers (including Angiopoietin-2, Procalcitonin, Resistin, IL-4Rα, MMP-8, TNFα, Renin, and IL-1α) were significantly associated with all-cause death. After multivariable adjustment, only angiopoietin-2 (Adjusted (Adj) hazard ratio (HR) per 1-unit increase in standardized biomarker concentrations 1.52 (95% CI 1.16–1.99)) and renin (Adj HR 1.32 (95% CI 1.06–1.65) remained independently associated with an increased risk of death. The discriminatory performance indicated good performance for angiopoietin-2 (area under the curve (AUC): 0.75 (95% CI 0.66–0.75) and was significantly higher (P = 0.011) as compared with renin (AUC: 0.60, 95% CI 0.50–0.60). In conclusion, angiopoietin-2 was significantly associated with all-cause mortality in patients with OHCA who survived the first 48 h and may prove to be useful for risk stratification of these patients.Thomas A. ZelnikerZiya KayaEva GamerdingerSebastian SpaichJan StiepakEvangelos GiannitsisHugo A. KatusMichael R. PreuschNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Thomas A. Zelniker Ziya Kaya Eva Gamerdinger Sebastian Spaich Jan Stiepak Evangelos Giannitsis Hugo A. Katus Michael R. Preusch Relationship between markers of inflammation and hemodynamic stress and death in patients with out-of-hospital cardiac arrest
description	Abstract Biomarkers that reflect hemodynamic stress, inflammation, extracellular matrix remodeling, angiogenesis, and endothelial dysfunction may improve risk stratification and add valuable pathobiological insight in patients with out-of-hospital cardiac arrest (OHCA). In total, 120 patients with OHCA who survived at least 48 h after return of spontaneous circulation were consecutively included in the present analysis. Concentrations of 30 biomarkers were measured simultaneously using a multi-panel biomarker assay. Cox regression models were adjusted for age, sex, estimated glomerular filtration rate, lactate concentration, bystander resuscitation, initial cardiac rhythm, and type of targeted temperature management. Overall, 57 patients (47.5%) had a favorable neurological outcome (Cerebral Performance Category ≤ 2) at 30 days, while palliative care was initiated in 49 patients (40.8%), and 52 patients (43.3%) died. After correction for multiple testing with Bonferroni-Holm, 8 biomarkers (including Angiopoietin-2, Procalcitonin, Resistin, IL-4Rα, MMP-8, TNFα, Renin, and IL-1α) were significantly associated with all-cause death. After multivariable adjustment, only angiopoietin-2 (Adjusted (Adj) hazard ratio (HR) per 1-unit increase in standardized biomarker concentrations 1.52 (95% CI 1.16–1.99)) and renin (Adj HR 1.32 (95% CI 1.06–1.65) remained independently associated with an increased risk of death. The discriminatory performance indicated good performance for angiopoietin-2 (area under the curve (AUC): 0.75 (95% CI 0.66–0.75) and was significantly higher (P = 0.011) as compared with renin (AUC: 0.60, 95% CI 0.50–0.60). In conclusion, angiopoietin-2 was significantly associated with all-cause mortality in patients with OHCA who survived the first 48 h and may prove to be useful for risk stratification of these patients.
format	article
author	Thomas A. Zelniker Ziya Kaya Eva Gamerdinger Sebastian Spaich Jan Stiepak Evangelos Giannitsis Hugo A. Katus Michael R. Preusch
author_facet	Thomas A. Zelniker Ziya Kaya Eva Gamerdinger Sebastian Spaich Jan Stiepak Evangelos Giannitsis Hugo A. Katus Michael R. Preusch
author_sort	Thomas A. Zelniker
title	Relationship between markers of inflammation and hemodynamic stress and death in patients with out-of-hospital cardiac arrest
title_short	Relationship between markers of inflammation and hemodynamic stress and death in patients with out-of-hospital cardiac arrest
title_full	Relationship between markers of inflammation and hemodynamic stress and death in patients with out-of-hospital cardiac arrest
title_fullStr	Relationship between markers of inflammation and hemodynamic stress and death in patients with out-of-hospital cardiac arrest
title_full_unstemmed	Relationship between markers of inflammation and hemodynamic stress and death in patients with out-of-hospital cardiac arrest
title_sort	relationship between markers of inflammation and hemodynamic stress and death in patients with out-of-hospital cardiac arrest
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/239a66f8605e48ec9d3aa7dba288ce58
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Relationship between markers of inflammation and hemodynamic stress and death in patients with out-of-hospital cardiac arrest

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