Biomarkers for outcome following cardiac arrest with therapeutic hypothermia treatment

Authors/year	Study design	Population	N	Bio-marker	Sample source	Findings
Tiainen, 2003	RCT	Witnessed VF or VT arrest, ≤60 min between collapse to ROSC	70	NSE, s100β	Serum	NSE levels were lower in TH compared to normothermia NSE did not reach 100 % specificity in TH, whereas it does in normothermia TH: NSE > 31.2 μg/L at 24 h, >26 μg/L at 36 h, and >25 μg/L at 48 h predicted poor outcome (96 % specificity) Normothermia: NSE > 13.3 μg/L at 24 h, > 12.6 μg/L at 36 h, and >8.8 μg/L at 48 h had 100 % specificity for poor outcome TH: s100β > 0.21 μg/L at 24 h (100 % specificity), s100β > 0.21 μg/L at 36 h and s100β > 0.23 μg/L at 48 h (96 % specificity) predicted poor outcome
Cronberg, 2011	Pro	Post cardiac arrest with GCS < 8 after ROSC	111	NSE	Serum	Elevated NSE was associated with worse outcome, DWI changes on MRI, and worse neuropathology All patients with NSE > 33 μg/L at 48 h died without regaining consciousness NSE > 27 μg/L predicted poor outcome at 6 months (100 % specificity)
Rundgren, 2009	Pro	In or out-of-hospital cardiac arrest, GCS ≤ 7	107	NSE, s100β	Serum	NSE > 28 μg/L at 48 h predicted poor 6-month outcome (100 % specificity; 67 % sensitivity) s100β > 0.51 μg/L at 24 h predicted poor 6-month outcome (96 % specificity; 62 % sensitivity)
Daubin, 2011	Pro	In or out-of-hospital cardiac arrest, comatose > 48 h	97	NSE	Serum	Elevated NSE correlated with worse outcome at 3 months NSE > 47 μg/L predicted poor 3-month outcome (84 % specificity; 72 % sensitivity) NSE > 97 μg/L predicted poor outcome (100 % PPV)
Shinozaki, 2009	Pro	In- or out-of-hospital non-traumatic cardiac arrest with ROSC > 20 min, with GCS ≤ 8	80	NSE, s100β	Serum	s100β and NSE are both elevated in poor outcome group. s100β had better predictive performance than NSE s100β cutoff for poor outcome are: s100β > 1.41 μg/L at admission, s100β > 0.21 μg/L at 6 h, and s100β > 0.05 μg/L at 24 h post cardiac arrest (100 % specificity)
Stammet, 2013	Pro	Post cardiac arrest	75	NSE, s100β	Serum	Elevated s100β and NSE levels are associated with poor outcome at 6 months Adding s100β to Bispectral index improved predictive value for poor outcome
Rosetti, 2012	Pro	Post cardiac arrest, comatose	61	NSE	Serum	Five cardiac arrest survivors, including three with good outcome, had NSE > 33 μg/L
Mortberg, 2011	Pro	Post cardiac arrest, SBP > 80 mmHg x > 5 min, GCS ≤ 7, <6 h following ROSC	31	NSE, s100β, BDNF, GFAP	Serum	No association between BDNF and GFAP levels and outcome NSE > 4.97 μg/L at 48 h and NSE > 3.22 μg/L at 96 h post cardiac arrest predicted poor outcome at 6 months (93 % specificity) s100β > 1.0 μg/L at 2 h (93 % specificity), and s100β > 0.18 μg/L at 24 h (100 % specificity) post cardiac arrest predicted poor outcome

PPV positive predictive value, Pro prospective observational, RCT randomized controlled trial, ROSC return of spontaneous circulation, TH therapeutic hypothermia, VF ventricular fibrillation, VT ventricular tachycardia