Post-cardiac arrest serum levels of glial fibrillary acidic protein for predicting neurological outcome

Larsson, Ing-Marie; Wallin, Ewa; Kristofferzon, Marja‐Leena; Niessner, Marion; Zetterberg, Henrik; Rubertsson, Sten

doi:10.1016/j.resuscitation.2014.09.007

Cited by 35 publications

(46 citation statements)

References 41 publications

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“…The cutoff values for S100 in this study are comparable with those described previously [7, 8, 25, 29]. Any differences might be due to different assays that might yield different values [20, 22, 23], different outcome measures [29], and sample size [23].…”

Section: Discussionsupporting

confidence: 82%

“…Adding S100 to our model including clinical characteristics and NSE did not further improve the accuracy of the model. Similar results have also been described by others when S100 was added to NSE [25]. Using a multivariable model with fewer variables, researchers in another study suggested the usefulness of S100 over NSE on admission [22].…”

Section: Discussionsupporting

confidence: 78%

“…S100 could distinguish patients with good and poor outcomes after OHCA because median values were higher in the poor outcome group, and this has been described in previous reports [18, 20–25]. It is noteworthy that S100 values declined over time in both temperature groups and for both outcome groups, indicating an early peak of this biomarker, which might explain why the first sample (at 24 h after ROSC) showed the best results [26].…”

Section: Discussionsupporting

confidence: 74%

“…However, a clear peak earlier than 24 h could not be determined in a previous study in which researchers investigated the kinetic profile of S100 [23]. Other studies have also confirmed a similar decline over time after 24 h in patients with good and poor outcomes [22, 25]. The early release and subsequent decline may be explained by the short half-life of approximately 2 h in combination with a low molecular weight, allowing a rapid transition through the blood-brain barrier [27].…”

Section: Discussionmentioning

confidence: 99%

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Protein S100 as outcome predictor after out-of-hospital cardiac arrest and targeted temperature management at 33 °C and 36 °C

et al. 2017

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BackgroundWe aimed to investigate the diagnostic performance of S100 as an outcome predictor after out-of-hospital cardiac arrest (OHCA) and the potential influence of two target temperatures (33 °C and 36 °C) on serum levels of S100.MethodsThis is a substudy of the Target Temperature Management after Out-of-Hospital Cardiac Arrest (TTM) trial. Serum levels of S100 were measured a posteriori in a core laboratory in samples collected at 24, 48, and 72 h after OHCA. Outcome at 6 months was assessed using the Cerebral Performance Categories Scale (CPC 1–2 = good outcome, CPC 3–5 = poor outcome).ResultsWe included 687 patients from 29 sites in Europe. Median S100 values were higher in patients with a poor outcome at 24, 48, and 72 h: 0.19 (IQR 0.10–0.49) versus 0.08 (IQR 0.06–0.11) μg/ml, 0.16 (IQR 0.10–0.44) versus 0.07 (IQR 0.06–0.11) μg/L, and 0.13 (IQR 0.08–0.26) versus 0.06 (IQR 0.05–0.09) μg/L (p < 0.001), respectively. The ability to predict outcome was best at 24 h with an AUC of 0.80 (95% CI 0.77–0.83). S100 values were higher at 24 and 72 h in the 33 °C group than in the 36 °C group (0.12 [0.07–0.22] versus 0.10 [0.07–0.21] μg/L and 0.09 [0.06–0.17] versus 0.08 [0.05–0.10], respectively) (p < 0.02). In multivariable analyses including baseline variables and the allocated target temperature, the addition of S100 improved the AUC from 0.80 to 0.84 (95% CI 0.81–0.87) (p < 0.001), but S100 was not an independent outcome predictor. Adding S100 to the same model including neuron-specific enolase (NSE) did not further improve the AUC.ConclusionsThe allocated target temperature did not affect S100 to a clinically relevant degree. High S100 values are predictive of poor outcome but do not add value to present prognostication models with or without NSE. S100 measured at 24 h and afterward is of limited value in clinical outcome prediction after OHCA.Trial registrationClinicalTrials.gov identifier: NCT01020916. Registered on 25 November 2009.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-017-1729-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 78%

Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

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Protein S100 as outcome predictor after out-of-hospital cardiac arrest and targeted temperature management at 33 °C and 36 °C

et al. 2017

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“…Similarly, in Hayashida et al, serum GFAP within first 24 hours of cardiac arrest was not predictive of outcome, but the sample size was small in addition to the relatively early time sampling time 25 . A larger, more recent study of 125 adults with cardiac arrest showed that while serum GFAP predicted outcomes, it was not superior to NSE or S100b, and when placed in an inclusive model, addition of GFAP did not improve predictive accuracy 26 . It should be noted that although neurologic injury is the leading cause of death after cardiac arrest, subjects also succumb from cardiovascular failure or multiorgan dysfunction, so a prognostication panel may benefit from inclusion of other organ biomarkers.…”

Section: Discussionmentioning

confidence: 93%

Exploratory study of serum ubiquitin carboxyl-terminal esterase L1 and glial fibrillary acidic protein for outcome prognostication after pediatric cardiac arrest

et al. 2016

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Introduction Brain injury is the leading cause of morbidity and death following pediatric cardiac arrest. Serum biomarkers of brain injury may assist in outcome prognostication. The objectives of this study were to evaluate the properties of serum ubiquitin carboxyl-terminal esterase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) to classify outcome in pediatric cardiac arrest. Methods Single center prospective study. Serum biomarkers were measured at 2 time points during the initial 72 h in children after cardiac arrest (n=19) and once in healthy children (controls, n=43). We recorded demographics and details of the cardiac arrest and resuscitation. We determined the associations between serum biomarker concentrations and Pediatric Cerebral Performance Category (PCPC) at 6 months (favorable (PCPC 1–3) or unfavorable (PCPC 4–6)). Results The initial assessment (time point 1) occurred at a median (IQR) of 10.5 (5.5–17.0) h and the second assessment (time point 2) at 59.0 (54.5–65.0) h post-cardiac arrest. Serum UCH-L1 was higher among children following cardiac arrest than among controls at both time points (p<0.05). Serum GFAP in subjects with unfavorable outcome was higher at time point 2 than in controls (p<0.05). Serum UCH-L1 at time point 1 (AUC 0.782) and both UCH-L1 and GFAP at time point 2 had good classification accuracy for outcome (AUC 0.822 and 0.796), p<0.05 for all. Conclusion Preliminary data suggest that serum UCH-L1 and GFAP may be of use to prognosticate outcome after pediatric cardiac arrest at clinically-relevant time points and should be validated prospectively.

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Differences Between Plasma and Cerebrospinal Fluid Glial Fibrillary Acidic Protein Levels Across the Alzheimer Disease Continuum

et al. 2021

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Translational Biomarkers in Aging and Dementia (TRIAD) study, Alzheimer's and Families (ALFA) study, and BioCogBank Paris Lariboisière cohort IMPORTANCE Glial fibrillary acidic protein (GFAP) is a marker of reactive astrogliosis that increases in the cerebrospinal fluid (CSF) and blood of individuals with Alzheimer disease (AD). However, it is not known whether there are differences in blood GFAP levels across the entire AD continuum and whether its performance is similar to that of CSF GFAP.OBJECTIVE To evaluate plasma GFAP levels throughout the entire AD continuum, from preclinical AD to AD dementia, compared with CSF GFAP.

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Post-cardiac arrest serum levels of glial fibrillary acidic protein for predicting neurological outcome

Cited by 35 publications

References 41 publications

Protein S100 as outcome predictor after out-of-hospital cardiac arrest and targeted temperature management at 33 °C and 36 °C

Protein S100 as outcome predictor after out-of-hospital cardiac arrest and targeted temperature management at 33 °C and 36 °C

Exploratory study of serum ubiquitin carboxyl-terminal esterase L1 and glial fibrillary acidic protein for outcome prognostication after pediatric cardiac arrest

Differences Between Plasma and Cerebrospinal Fluid Glial Fibrillary Acidic Protein Levels Across the Alzheimer Disease Continuum

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