CT-proAVP (copeptin), MR-proANP and Peroxiredoxin 4 after cardiac arrest: release profiles and correlation to outcome.

Abstract

BACKGROUND:

Further characterization of the post-cardiac arrest syndrome (PCAS) is essential to better understand the mechanisms resulting in injury and death. We investigated serial serum concentrations of the stress hormone c-terminal provasopressin (CT-proAVP or copeptin), the cardiac biomarker MR-proANP and a biomarker of oxidation injury, Peroxiredoxin 4 (Prx4) in patients treated with mild hypothermia (MHT) after cardiac arrest, and studied their association to the PCAS and long-term outcome.

METHODS:

Serum samples from cardiac arrest patients were collected serially: at admission, 2, 6, 12, 24, 36, 48 and 72 h after cardiac arrest. CT-proAVP, MR-proANP and Prx4 concentrations were determined and tested for association with two surrogate markers of PCAS (time to return of spontaneous circulation and circulation-SOFA score) and with cerebral performance category (CPC) at 6 months. Good outcome was defined as CPC 1 to 2.

RESULTS:

Eighty-four patients were included. CT-proAVP, MR-proANP and Prx4 were early biomarkers with maximum concentrations soon after cardiac arrest and with a significant discriminatory ability between good and poor long-term outcome at most time points. CT-proAVP predicted a poor outcome with the highest accuracy, followed by MR-proANP and Prx4 (area under the receiving operating characteristics curve at 12 h of 0.85, 0.77 and 0.76 respectively). CT-proAVP and MR-proANP showed best correlation to the PCAS.

CONCLUSION:

In 84 resuscitated patients receiving MHT after cardiac arrest, there is a significant difference in concentrations of CT-proAVP, MR-proANP and Prx4 between patients with good and poor outcome. CT-proAVP and MR-proANP have a significant correlation to surrogate markers of the PCAS.

• Authors: M Annborn, J Dankiewicz, N Nielsen, M Rundgren, J G Smith, S Hertel, J Struck, H Friberg
• Journal: Acta anaesthesiologica Scandinavica (Acta Anaesthesiol Scand) Vol. 58 Issue 4 Pg. 428-36 (Apr 2014) ISSN: 1399-6576 [Electronic] England
• PMID: 24617620 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Chemical References

• Biomarkers
• Glycopeptides
• copeptins
• midregional pro-atrial natriuretic peptide, human
• Atrial Natriuretic Factor
• Peroxiredoxins

Topics

• Aged
• Atrial Natriuretic Factor (blood)
• Biomarkers (blood)
• Female
• Glycopeptides (blood)
• Heart Arrest (metabolism, therapy)
• Humans
• Hypothermia, Induced
• Male
• Middle Aged
• Peroxiredoxins (blood)
• Predictive Value of Tests
• Prognosis
• ROC Curve
• Treatment Outcome