title: MIF reflects tissue damage rather than inflammation in post-cardiac arrest syndrome in a real life cohort.
abstract: BACKGROUND
  Following successful resuscitation from cardiac arrest (CA), neurological impairment and other types of organ dysfunction cause significant morbidity and mortality-a condition termed post-cardiac arrest syndrome. Whole-body ischemia/reperfusion with oxygen debt activates immunologic and coagulation pathways increasing the risk of multiple organ failure and infection. We here examined the role of the pro-inflammatory cytokine macrophage migration inhibitory factor (MIF) in post-cardiac arrest syndrome.
  
  
  METHODS
  MIF plasma levels of n=16 patients with return of spontaneous circulation (ROSC) after CA were assessed with a previously validated method and compared to markers of systemic inflammation and cellular damage. ICU patients without former CA and healthy volunteers served as controls.
  
  
  RESULTS
  MIF levels in patients after ROSC were higher compared to those in healthy volunteers and ICU patients without CA. Kaplan-Meyer analysis revealed a distinctly elevated mortality since day one that further increased towards an elevated 60-days-mortality in patients with high plasma MIF. ROC curve identified plasma MIF as a predictor for mortality in patients after CA. Correlation with inflammatory parameters revealed that high MIF levels did not mirror post CA inflammatory syndrome, but distinctive cellular damage after ROSC as there were strong correlations with markers of cellular damage like LDH and GOT/GPT.
  
  
  CONCLUSIONS
  High MIF levels were associated with elevated 60-days-mortality and high MIF predicted mortality after CA. We found a close relation between circulating MIF levels and cellular damage, but not with an inflammatory syndrome.
authors.affiliation: University Hospital Essen, West German Heart and Vascular Center, Department of Cardiology, Hufelandstr. 55, Essen 45147, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Pohl
authors.affiliation: University Hospital Essen, West German Heart and Vascular Center, Department of Cardiology, Hufelandstr. 55, Essen 45147, Germany.
authors.forename: Christos
authors.initials: C
authors.lastname: Rammos
authors.affiliation: University Hospital Essen, West German Heart and Vascular Center, Department of Cardiology, Hufelandstr. 55, Essen 45147, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Totzeck
authors.affiliation: University Hospital Essen, West German Heart and Vascular Center, Department of Cardiology, Hufelandstr. 55, Essen 45147, Germany.
authors.forename: Pia
authors.initials: P
authors.lastname: Stock
authors.affiliation: University Hospital Duesseldorf, Medical Faculty Heinrich-Heine-University, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, Duesseldorf D-40225, Germany.
authors.forename: Malte
authors.initials: M
authors.lastname: Kelm
authors.affiliation: University Hospital Essen, West German Heart and Vascular Center, Department of Cardiology, Hufelandstr. 55, Essen 45147, Germany.
authors.forename: Tienush
authors.initials: T
authors.lastname: Rassaf
authors.affiliation: University Hospital Essen, West German Heart and Vascular Center, Department of Cardiology, Hufelandstr. 55, Essen 45147, Germany. Electronic address: Peter.Luedike@uk-essen.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Luedike
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D016887:Cardiopulmonary Resuscitation; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006323:Heart Arrest / Q000097:blood / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007362:Intensive Care Units; D019746:Intramolecular Oxidoreductases / Q000097:blood*; D008263:Macrophage Migration-Inhibitory Factors / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology*; D011446:Prospective Studies; D012372:ROC Curve; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D008263:Macrophage Migration-Inhibitory Factors; D019746:Intramolecular Oxidoreductases; C515598:MIF protein, human
keywords: CPR; Cardiac arrest; ICU; MIF