Resuscitation plus · 2026
Serial plasma proenkephalin A 119-159 and dipeptidyl peptidase 3 after cardiac arrest: association with long-term neurological outcome.
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Þorgeirsdóttir Bergþóra, Lybeck Anna, Friberg Hans, Frigyesi Attila
Аннотация
UNLABELLED: To evaluate whether serial plasma proenkephalin A 119-159 (penKid) and circulating dipeptidyl peptidase 3 (cDPP3) after cardiac arrest are associated with long-term neurological outcome and mortality.
METHODS: We performed a retrospective multicentre cohort study of adults admitted to intensive care after cardiac arrest in southern Sweden. Biomarkers were measured on admission and at 12 and 48 h. The primary outcome was poor neurological outcome, defined as Cerebral Performance Category 3-5 at 2-6 months. The secondary outcome was 180-day mortality. Models were adjusted for established peri-arrest prognostic variables. Odds ratios and hazard ratios are reported per 1-SD increase in log10transformed biomarker concentration.
RESULTS: Among 417 patients, 271 (65%) had poor neurological outcome and 266 (64%) died within 180 days. PenKid was independently associated with poor neurological outcome at admission (adjusted odds ratio 1.62, 95% confidence interval 1.15-2.28) and 12 h (1.50, 1.08-2.09), and with mortality at admission (adjusted hazard ratio 1.36, 1.20-1.54) and 12 h (1.33, 1.17-1.51). cDPP3 was independently associated with mortality at 12 h (1.26, 1.11-1.43), but not with poor neurological outcome after adjustment. Neither biomarker significantly improved discrimination beyond the clinical reference model.
CONCLUSIONS: Early penKid was associated with poor neurological outcome and mortality after cardiac arrest, whereas cDPP3 was associated with mortality at 12 h. These biomarkers added limited discriminatory value beyond established clinical predictors.
METHODS: We performed a retrospective multicentre cohort study of adults admitted to intensive care after cardiac arrest in southern Sweden. Biomarkers were measured on admission and at 12 and 48 h. The primary outcome was poor neurological outcome, defined as Cerebral Performance Category 3-5 at 2-6 months. The secondary outcome was 180-day mortality. Models were adjusted for established peri-arrest prognostic variables. Odds ratios and hazard ratios are reported per 1-SD increase in log10transformed biomarker concentration.
RESULTS: Among 417 patients, 271 (65%) had poor neurological outcome and 266 (64%) died within 180 days. PenKid was independently associated with poor neurological outcome at admission (adjusted odds ratio 1.62, 95% confidence interval 1.15-2.28) and 12 h (1.50, 1.08-2.09), and with mortality at admission (adjusted hazard ratio 1.36, 1.20-1.54) and 12 h (1.33, 1.17-1.51). cDPP3 was independently associated with mortality at 12 h (1.26, 1.11-1.43), but not with poor neurological outcome after adjustment. Neither biomarker significantly improved discrimination beyond the clinical reference model.
CONCLUSIONS: Early penKid was associated with poor neurological outcome and mortality after cardiac arrest, whereas cDPP3 was associated with mortality at 12 h. These biomarkers added limited discriminatory value beyond established clinical predictors.