Serum glial fibrillary acidic protein as a predictive biomarker of neurological outcome after cardiac arrest.

Abstract

Serum glial fibrillary acidic protein (GFAP) has recently been identified as a specific predictor of brain damage and neurological outcome in patients with head trauma. In this study, serum GFAP was assessed as a predictor of neurological outcome in post-cardiac-arrest (PCA) patients. This study was a retrospective, single-medical-center analysis, conducted in the intensive care unit of a university hospital. Forty-four sequential PCA patients with cardiogenic or non-cardiogenic arrest were included. The patients were treated with or without therapeutic hypothermia (TH). Serum samples were collected from the patients at 12, 24, and 48h after the return of spontaneous circulation (ROSC). Serum GFAP concentrations were measured by enzyme-linked immunosorbent assay and compared in patients with good and poor neurological outcomes, evaluated over a period of 6 months using Glasgow Outcome Scale. Serum GFAP was significantly higher in patients with a poor outcome at 12 and 24h without TH and at 48h with TH (P<0.05). GFAP (>0.1ngdL(-1)) was a specific predictor of poor neurological outcome at 6 months with or without TH treatment. Although this study is preliminary, serum GFAP after ROSC reflected a poor neurological outcome in PCA patients.