Proteomics strategies to develop accurate neuro-prognostic biomarkers for comatose survivors of cardiac arrest
SEA-17-001 Providing accurate neurologic prognosis for survivors of cardiac arrest is one of the most difficult challenges facing ICU clinicians. This study was designed to assess whether proteomic strategies could be used to identify novel serum biomarkers that can predict neurological recovery after cardiac arrest. We have identified 2 novel markers of poor neurological prognosis, muskelin and protein 14-3-3. We are currently validating these markers, and exploring new tools to identify novel markers in a multicentre study.
SEA-17-001 Many of the 10 000 Canadians who survive out of hospital cardiac arrest each year are left with severe neurological deficits. Others however, especially those who are treated with targeted temperature management (TTM), survive with little or no neurological deficit. Serum biomarkers have been previously used to help predict neurological recovery after arrest, but are unreliable for patients treated with TTM. This prospective cohort feasibility study has recruited adults who have been resuscitated from cardiac arrest due to ventricular fibrillation or pulseless ventricular tachycardia. Serum was collected every 12 hours for the first 72h after cardiac arrest. Outcome was based on their cerebral performance category (CPC) at 3 months, with a good outcome defined as CPC 1-3 (normal to moderate neurological disability), and a poor outcome defined as CPC 4-5 (persistent vegetative state or death). Prior to proteomic analysis, the serum was depleted of high abundance proteins with a commercially available column. Our preliminary data identified two novel biomarkers, 14-3-3 and muskelin, only in the serum of individuals with poor neurological outcome. Muskelin may be of particular interest, as it is a neuron-specific marker, that is involved in shuttling GABAa receptors to the cell surface. We are currently in the final phases of enrolling participants in a in a multi-centre study to validate these findings.