title: Neurofilament light chain as an early and sensitive predictor of long-term neurological outcome in patients after cardiac arrest.
abstract: BACKGROUND
  Neurofilament light chain (NF-L) is the major intermediate filament specifically expressed in neurons and their axons. No data are available concerning serum levels of NF-L after global cerebral ischemia due to cardiac arrest. To find a specific neuronal marker of long-term neurological outcome, we examined serum levels of NF-L in patients after cardiac arrest.
  
  
  METHODS
  A prospective observational cohort study was conducted. Blood samples for the measurement of NF-L were analyzed from 85 patients within 2h after admission, as well as on 2nd, 3rd, 5th, and 7th day. Neurological outcome was assessed 6 months after cardiac arrest by employing the Modified Glasgow Outcome Score (MGOS).
  
  
  RESULTS
  The serum course of NF-L in patients with poor neurological outcome (MGOS 1+2) was significantly augmented compared to patients with good neurological outcome (MGOS 3+4+5) (on admission (pg/ml): good: 125 ± 11.7 vs. poor: 884.4 ± 86.2 pg/ml; 3rd day: good: 153.1 ± 13.2 vs. poor: 854.4 ± 119.1; 7th day: good: 112.5 ± 10.4 vs. poor: 1011.8 ± 100.8; P<0.001). Intermediate NF-L serum values were found in patients with MGOS 0, which represents a mixture of patients who died with and without certified brain damage (on admission (pg/dl): 433.7 ± 49.8; 3rd day: 598.3 ± 86.6; 7th day: 474 ± 77.4). A prediction power of 0.93 (c-statistic, 95%-CI 0.87-0.99) on 1st, 0.85 (0.81-0.95) on 2nd, 0.92 (0.85-0.99) on 3rd, 0.97 (0.92-1) on 5th and 0.99 (0.98-1) on 7th day was achieved for NF-L predicting poor neurological outcome.
  
  
  CONCLUSIONS
  The present data suggest that within 7 days after cardiac arrest serum NF-L is a valuable marker of long-term neurological outcome.
authors.affiliation: Department of Cardiology, University Hospital Düsseldorf, Düsseldorf, Germany. Electronic address: rana.obaida@googlemail.com.
authors.forename: Obaida R
authors.initials: OR
authors.lastname: Rana
authors.forename: Jörg W
authors.initials: JW
authors.lastname: Schröder
authors.forename: Julia K
authors.initials: JK
authors.lastname: Baukloh
authors.forename: Esra
authors.initials: E
authors.lastname: Saygili
authors.forename: Karl
authors.initials: K
authors.lastname: Mischke
authors.forename: Johannes
authors.initials: J
authors.lastname: Schiefer
authors.forename: Joachim
authors.initials: J
authors.lastname: Weis
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Marx
authors.forename: Tienush
authors.initials: T
authors.lastname: Rassaf
authors.forename: Malte
authors.initials: M
authors.lastname: Kelm
authors.forename: Dong-In
authors.initials: DI
authors.lastname: Shin
authors.forename: Christian
authors.initials: C
authors.lastname: Meyer
authors.forename: Erol
authors.initials: E
authors.lastname: Saygili
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D042241:Early Diagnosis; D005260:Female; D006323:Heart Arrest / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D016900:Neurofilament Proteins / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D016900:Neurofilament Proteins; C044882:neurofilament protein L
keywords: Cardiac arrest; Cardiopulmonary resuscitation; Modified Glasgow Outcome Score (MGOS); Neurofilament