Association of Taurine with In-Hospital Mortality in Patients after Out-of-Hospital Cardiac Arrest: Results from the Prospective, Observational COMMUNICATE Study.

Naemi Herzog,Stephan Marsch,Madlaina Widmer,Raoul Sutter,Katharina Beck,Emanuel Thommen,Sebastian Perrig,Peter Neyer,Kai Tisljar,Philipp Schuetz,Rahel Laager,Alessia M Vincent,Sabina Hunziker,Christoph Becker,Annalena Keller,Luca Bernasconi

doi:10.3390/jcm9051405

Abstract

Background: Studies have suggested that taurine may have neuro- and cardio-protective functions, but there is little research looking at taurine levels in patients after out-of-hospital cardiac arrest (OHCA). Our aim was to evaluate the association of taurine with mortality and neurological deficits in a well-defined cohort of OHCA patients. Methods: We prospectively measured serum taurine concentration in OHCA patients upon admission to the intensive care unit (ICU) of the University Hospital Basel (Switzerland). We analyzed the association of taurine levels and in-hospital mortality (primary endpoint). We further evaluated neurological outcomes assessed by the cerebral performance category scale. We calculated logistic regression analyses and report odds ratios (OR) and 95% confidence intervals (CI). We calculated different predefined multivariable regression models including demographic variables, comorbidities, initial vital signs, initial blood markers and resuscitation measures. We assessed discrimination by means of area under the receiver operating curve (ROC). Results: Of 240 included patients, 130 (54.2%) survived until hospital discharge and 110 (45.8%) had a favorable neurological outcome. Taurine levels were significantly associated with higher in-hospital mortality (adjusted OR 4.12 (95%CI 1.22 to 13.91), p = 0.02). In addition, a significant association between taurine concentration and a poor neurological outcome was observed (adjusted OR of 3.71 (95%CI 1.13 to 12.25), p = 0.03). Area under the curve (AUC) suggested only low discrimination for both endpoints (0.57 and 0.57, respectively). Conclusion: Admission taurine levels are associated with mortality and neurological outcomes in OHCA patients and may help in the risk assessment of this vulnerable population. Further studies are needed to assess whether therapeutic modulation of taurine may improve clinical outcomes after cardiac arrest.

Highlights

A cardiac arrest is a serious medical condition and often leads to adverse outcomes such as cognitive and functional disabilities and death [1,2,3]
Lombardini et al observed that taurine levels in patients with acute myocardial injury were associated with severity of myocardial infarction [18]
A total of 240 patients with out-of-hospital cardiac arrests and successful resuscitation were included in this analysis

Summary

Introduction

A cardiac arrest is a serious medical condition and often leads to adverse outcomes such as cognitive and functional disabilities and death [1,2,3]. Different blood markers including metabolomic markers have been proposed to improve risk stratification and decision making [5]. Among these metabolites, the aminoethanesulfonic acid taurine, which is best known as an ingredient in common energy drinks, is an interesting marker for neurological injury. Our aim was to evaluate the association of taurine with mortality and neurological deficits in a well-defined cohort of OHCA patients. A significant association between taurine concentration and a poor neurological outcome was observed (adjusted OR of 3.71 (95%CI 1.13 to 12.25), p = 0.03). Conclusion: Admission taurine levels are associated with mortality and neurological outcomes in OHCA patients and may help in the risk assessment of this vulnerable population. Further studies are needed to assess whether therapeutic modulation of taurine may improve clinical outcomes after cardiac arrest

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