Resistin-Can it be a new early marker for prognosis in patients who survive after a cardiac arrest? A pilot study.

Raluca Mihaela Tat,Adela Golea,Ştefan Cristian Vesa,Daniela Ionescu,Tatsuo Shimosawa

doi:10.1371/journal.pone.0210666

Abstract

AimThe aim of our study was to evaluate the potential role of resistin in estimating the 30 days prognosis in patients with hypoxic-ischemic organ injury who survived after a cardiac arrest (CA).Materials and methodsThe study included 40 patients resuscitated after a non-traumatic out-of-hospital CA admitted in Emergency Department (ED). All patients were followed for 30 days after CA or until death. Clinical data on admission were recorded. Blood samples were collected on admission in ED (0-time interval), and at 6, 12, 24, 48- and 72-hours following resuscitation. Serum concentrations of resistin, S100B and neuron specific enolase (NSE) were measured. Several predictive scores for the mortality at 30 days were created with logistic regressions.ResultsAt each time interval, median serum levels of resistin and S100 B were significantly higher in non-survivors compared to survivors. For NSE, plasma levels were significantly lower in survivors as compared to non-survivors at 48 and 72 hours, respectively. Accurate predictive scores for 30-days mortality were the ones which included the values of resistin and S100B measured at 12 hours after admittance [AUC 0.938 (0.813–0.989), sensitivity 85.71% (67.3%– 96%), specificity 91.67% (61.5%’99.8%), p<0.001], which included the values of all three markers measured at 12 hours after admittance [AUC 0.955 (0.839–0.995), sensitivity 82.14% (63.1%’93.9%), specificity 100.00% (73.5%’100.0%), p<0.001] and the that included the values of resistin and S-100B at 6 hours together with serum lactate on admission [AUC = 0.994 (0.901–1.0), sensitivity 96.4% (81.7%’99.9%), specificity 100.00% (73.5%’100.0%), p<0.001].ConclusionIn our study, serum levels of resistin or a combination of resistin with S-100B or resistin with S-100B and lactate, were highly predictive for 30 days mortality in resuscitated patients after CA. Further studies on large number of patients are needed to confirm our data.

Highlights

At present, hypoxic-ischemic organ injury after cardiac arrest (CA) remains a major health problem due to increased mortality, morbidity and length of hospital stay
Median serum levels of resistin and S100 B were significantly higher in non-survivors compared to survivors
For neuron specific enolase (NSE), plasma levels were significantly lower in survivors as compared to non-survivors at 48 and 72 hours, respectively

Summary

Introduction

Hypoxic-ischemic organ injury after cardiac arrest (CA) remains a major health problem due to increased mortality, morbidity and length of hospital stay. Most of the hospital stay is pent in intensive care units, which leads to increased costs and implications for health system, patient and family. Majority of these patients have poor outcomes. Numerous attempts have been made to identify those patients with high chances of favorable outcome after return of spontaneous circulation (ROSC). In these cases efforts should be made to obtain full recovery. In the past years a number of studies focused on the potential role of biomarkers, along with clinical and imagistic criteria in estimating outcomes in patients who suffer an out-of-/in-hospital CA [4,5,6,7,8]

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Results