title: Influence of mannan-binding lectin and MAp44 on outcome in comatose survivors of out-of-hospital cardiac arrest.
abstract: OBJECTIVE
  The lectin complement pathway, initiated by mannan-binding-lectin (MBL) plays a role in tissue destruction following ischemia/reperfusion, and MBL deficiency has been associated with favorable outcome in stroke patients. MAp44 is produced in the heart and may theoretically function as an endogenous inhibitor of MBL-mediated activities. The aim of this study was to investigate the possible association between MBL deficiency, MAp44 levels and outcome in comatose survivors of out-of-hospital cardiac arrest (OHCA).
  
  
  METHODS
  In a single center post hoc analysis of the prospective multicenter randomized Target Temperature Management (TTM) trial, we measured MBL and MAp44 levels at baseline, 24, 48 and 72 h after OHCA in 169 consecutive patients randomly assigned to TTM at 33 °C or 36 °C for 24h. Primary outcome was 30 days mortality and secondary outcome was favorable neurological outcome assessed by Cerebral Performance Category (CPC1-2) and modified Rankin Scale (mRS0-3) 180 days after OHCA.
  
  
  RESULTS
  Patients with MBL deficiency (defined as plasma levels ≤100 ngml(-1) at baseline) (n=22) carried a 30-day mortality of 41% compared to 32% in MBL sufficient patient (n=147), p=0.55. Baseline MAp44 levels were not associated with mortality, p=0.25. There was no significant difference in neurological outcome between the two MBL groups assessed by CPC (p=0.69) and mRS (p=0.91). In multivariable models, baseline MBL (OR=1.0, p=0.70), (OR=1.5, p=0.30) and MAp44 levels (OR=1.0, p=0.99), (OR=1.6, p=0.21) were not associated with favorable neurological outcome assessed by CPC and mRS, respectively.
  
  
  CONCLUSIONS
  In comatose survivors after cardiac arrest, neither MBL deficiency nor levels of MBL and MAp44 were associated with mortality or neurological outcome.
authors.affiliation: Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Denmark; Department of Cardiology, Aarhus University Hospital, Skejby, Denmark. Electronic address: jbj@dadlnet.dk.
authors.forename: John
authors.initials: J
authors.lastname: Bro-Jeppesen
authors.affiliation: Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Kjaergaard
authors.affiliation: Department of Biomedicine, Aarhus University, Aarhus, Denmark.
authors.forename: Steffen
authors.initials: S
authors.lastname: Thiel
authors.affiliation: Department of Biomedicine, Aarhus University, Aarhus, Denmark.
authors.forename: Jens Christian
authors.initials: JC
authors.lastname: Jensenius
authors.affiliation: The Medical Research Laboratories, Department of Clinical Medicine, Aarhus University, Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Bjerre
authors.affiliation: Department of Cardiothoracic Anaesthesia, The Heart Centre, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Michael
authors.initials: M
authors.lastname: Wanscher
authors.affiliation: Slotsbakken 160, 2970 Hørsholm, Denmark.
authors.forename: Jeppe V
authors.initials: JV
authors.lastname: Christensen
authors.affiliation: Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Hassager
mesh_terms: D003128:Coma / Q000097:blood* / Q000209:etiology / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D037601:Mannose-Binding Lectin / Q000172:deficiency*; D050606:Mannose-Binding Protein-Associated Serine Proteases / Q000032:analysis*; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000097:blood* / Q000150:complications / Q000401:mortality*; D011446:Prospective Studies; D016037:Single-Blind Method; D015996:Survival Rate
chemical_list: D037601:Mannose-Binding Lectin; C084067:MASP1 protein, human; D050606:Mannose-Binding Protein-Associated Serine Proteases
keywords: Cardiac arrest; Complement; Hypothermia; Mannan-binding lectin; Post-cardiac arrest syndrome