Growth differentiation factor 15 and early prognosis after out-of-hospital cardiac arrest
Rueda, Ferran (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Cediel, Germán (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Garcia Garcia, Cosme (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Aranyó, Júlia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
González-Lopera, Marta (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Aranda-Nevado, M. Cruz (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Serra Gregori, Judith (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Oliveras, Teresa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Labata, Carlos (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ferrer Massot, Marc (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
El Ouaddi, Nabil (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bayés-Genís, Antoni (Universitat Autònoma de Barcelona. Departament de Medicina)

Fecha:	2019
Resumen:	Background: Growth differentiation factor 15 (GDF-15) is an inflammatory cytokine released in response to tissue injury. It has prognostic value in cardiovascular diseases and other acute and chronic conditions. Here, we explored the value of GDF-15 as an early predictor of neurologic outcome after an out-of-hospital cardiac arrest (OHCA). Methods: Prospective registry study of patients in coma after an OHCA, admitted in the intensive cardiac care unit from a single university center. Serum levels of GDF-15 were measured on admission. Neurologic status was evaluated according to the cerebral performance category (CPC) scale. The relationship between GDF-15 levels and poor neurologic outcome at 6 months was analyzed. Results: Among 62 patients included, 32 (51. 6%) presented poor outcome (CPC 3-5). Patients with CPC 3-5 exhibited significantly higher GDF-15 levels (median, 17. 1 [IQR, 11. 1-20. 4] ng/mL) compared to those with CPC 1-2 (7. 6 [IQR, 4. 1-13. 1] ng/mL; p = 0. 004). Multivariable logistic regression analyses showed that age (OR, 1. 09; 95% CI 1. 01-1. 17; p = 0. 020), home setting arrest (OR, 8. 07; 95% CI 1. 61-40. 42; p = 0. 011), no bystander cardiopulmonary resuscitation (OR, 7. 91; 95% CI 1. 84-34. 01; p = 0. 005), and GDF-15 levels (OR, 3. 74; 95% CI 1. 32-10. 60; p = 0. 013) were independent predictors of poor outcome. The addition of GDF-15 in a dichotomous manner (≥ 10. 8 vs. < 10. 8 ng/mL) to the resulting clinical model improved discrimination; it increased the area under the curve from 0. 867 to 0. 917, and the associated continuous net reclassification improvement was 0. 90 (95% CI 0. 48-1. 44), which allowed reclassification of 37. 1% of patients. Conclusions: After an OHCA, increased GDF-15 levels were an independent, early predictor of poor neurologic outcome. Furthermore, when added to the most common clinical factors, GDF-15 improved discrimination and allowed patient reclassification.
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Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Out-of-hospital cardiac arrest ; Prognostication ; Neurologic outcome ; Growth differentiation factor 15 ; Biomarkers
Publicado en:	Annals of Intensive Care, Vol. 9 (2019) , p. 119, ISSN 2110-5820

DOI: 10.1186/s13613-019-0593-9
PMID: 31624933

10 p, 930.0 KB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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