Nav: Home

Protein from injured neurons predicts brain recovery after out-of-hospital heart attack

January 18, 2017

The biomarker neuron-specific enolase is a strong predictor of brain recovery in heart attack patients who are unconscious for three or more days, according to a study published January 18, 2017, in the journal PLOS ONE by Sebastian Wiberg from Copenhagen University Hospital in Denmark and colleagues.

When people suffer cardiac arrests out-of-hospital, their brains may be oxygen-deprived for some time, causing neurological injuries and loss of consciousness. Neurological injury from lack of oxygen is the primary cause of death following cardiac arrest, so accurate prognostic information about brain recovery is key to making decisions about patient care.

The authors of the present study retrospectively examined a subset of data collected during the Targeted Temperature Management (TTM) clinical trial, which examined the benefits of lowering body temperatures in patients who had suffered heart attacks out-of-hospital. Wiberg and colleagues analyzed data from the TTM trial on 685 adults who had been admitted to hospital in a comatose state after suffering a cardiac arrest. These patients' blood was drawn one, two and three days after the heart attack to measure levels of the protein biomarker neuron-specific enolase (NSE), which is released into the blood by injured nerves.

After conducting statistical analyses of this subset of data, the researchers found that for patients who remained comatose for three days or longer, a combination of all three NSE measurements was a strong predictor of recovery outcomes. The NSE measurement taken two days after cardiac arrest was particularly useful. However, NSE was not a useful outcome predictor for patients who awakened from comas within 3 days.

Current guidelines for management of comatose cardiac arrest patients call for serial measurements of NSE, advice which is supported by this study. However, the authors note that a prospective cohort study should be done to verify these results.
-end-
In your coverage please use this URL to provide access to the freely available paper: http://dx.plos.org/10.1371/journal.pone.0168894

Citation: Wiberg S, Hassager C, Stammet P, Winther-Jensen M, Thomsen JH, Erlinge D, et al. (2017) Single versus Serial Measurements of Neuron-Specific Enolase and Prediction of Poor Neurological Outcome in Persistently Unconscious Patients after Out-Of-Hospital Cardiac Arrest - A TTM-Trial Substudy. PLoS ONE 12(1): e0168894. doi:10.1371/journal.pone.0168894

Funding: The TTM-Trial was funded by independent research grants from the Swedish Heart Lung Foundation; Arbetsmarknadens Försäkringsaktiebolag Insurance Foundation; Swedish Research Council; regional research support, Region Skåne; governmental funding of clinical research within the Swedish National Health Services; Thelma Zoega Foundation; Krapperup Foundation; Thure Carlsson Foundation; Hans-Gabriel and Alice Trolle-Wachtmeister Foundation for Medical Research; Skåne University Hospital, Sweden; TrygFonden, Denmark; the European Clinical Research Infrastructures Network; and the European Critical Care Research Network. There was no commercial funding. Funding organizations neither had any access to the data nor had any influence on the analysis or interpretation.

Competing Interests: The authors have declared that no competing interests exist.

PLOS

Related Heart Attack Articles:

Heart cells respond to heart attack and increase the chance of survival
The heart of humans and mice does not completely recover after a heart attack.
A simple method to improve heart-attack repair using stem cell-derived heart muscle cells
The heart cannot regenerate muscle after a heart attack, and this can lead to lethal heart failure.
Mount Sinai discovers placental stem cells that can regenerate heart after heart attack
Study identifies new stem cell type that can significantly improve cardiac function.
Fixing a broken heart: Exploring new ways to heal damage after a heart attack
The days immediately following a heart attack are critical for survivors' longevity and long-term healing of tissue.
Heart patch could limit muscle damage in heart attack aftermath
Guided by computer simulations, an international team of researchers has developed an adhesive patch that can provide support for damaged heart tissue, potentially reducing the stretching of heart muscle that's common after a heart attack.
How the heart sends an SOS signal to bone marrow cells after a heart attack
Exosomes are key to the SOS signal that the heart muscle sends out after a heart attack.
Heart attack patients taken directly to heart centers have better long-term survival
Heart attack patients taken directly to heart centers for lifesaving treatment have better long-term survival than those transferred from another hospital, reports a large observational study presented today at Acute Cardiovascular Care 2019, a European Society of Cardiology congress.
Among heart attack survivors, drug reduces chances of second heart attack or stroke
In a clinical trial involving 18,924 patients from 57 countries who had suffered a recent heart attack or threatened heart attack, researchers at the University of Colorado Anschutz Medical Campus and fellow scientists around the world have found that the cholesterol-lowering drug alirocumab reduced the chance of having additional heart problems or stroke.
Oxygen therapy for patients suffering from a heart attack does not prevent heart failure
Oxygen therapy does not prevent the development of heart failure.
I have had a heart attack. Do I need open heart surgery or a stent?
New advice on the choice between open heart surgery and inserting a stent via a catheter after a heart attack is launched today.
More Heart Attack News and Heart Attack Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Rethinking Anger
Anger is universal and complex: it can be quiet, festering, justified, vengeful, and destructive. This hour, TED speakers explore the many sides of anger, why we need it, and who's allowed to feel it. Guests include psychologists Ryan Martin and Russell Kolts, writer Soraya Chemaly, former talk radio host Lisa Fritsch, and business professor Dan Moshavi.
Now Playing: Science for the People

#538 Nobels and Astrophysics
This week we start with this year's physics Nobel Prize awarded to Jim Peebles, Michel Mayor, and Didier Queloz and finish with a discussion of the Nobel Prizes as a way to award and highlight important science. Are they still relevant? When science breakthroughs are built on the backs of hundreds -- and sometimes thousands -- of people's hard work, how do you pick just three to highlight? Join host Rachelle Saunders and astrophysicist, author, and science communicator Ethan Siegel for their chat about astrophysics and Nobel Prizes.