The association between lipid profiles and the neurologic outcome in patients with out-of-hospital cardiac arrest.

Abstract

Lipid profiles are known to be a risk factor for development of cardiovascular disease. However, the relationship between lipid profiles and outcome in out-of-hospital cardiac arrest (OHCA) survivors remains unclear. We aimed to examine the association between lipid profiles and neurologic outcome in OHCA survivors. This retrospective observational study included adult (≥18 years) OHCA survivors between January 2016 and December 2018. We measured patients' lipid profiles after return of spontaneous circulation (ROSC) including total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride. The primary outcome was neurologic outcome at hospital discharge. Good neurologic outcome was defined cerebral performance categories 1 and 2. A total of 182 patients were included. Of them, 57 (31.3%) were discharged with good neurologic outcomes. Median serum levels of total cholesterol (178.0 vs. 123.0 mg/dL), HDL (44.0 vs. 31.0 mg/dL), and LDL (104.0 vs. 75.0 mg/dL) were significantly higher in patients with good neurologic outcome. The area under the curves of total cholesterol, HDL, LDL, and triglyceride were 0.742 (95% confidence interval [CI], 0.672-0.803), 0.729 (95% CI, 0.658-0.792), 0.683 (95% CI, 0.610-0.750), and 0.572 (95% CI, 0.497-0.645), respectively. Total cholesterol (odds ratio [OR], 1.013; 95% CI, 1.000-1.025; p = 0.043) and HDL (OR, 1.071; 95% CI, 1.021-1.123; p = 0.005) levels were associated with good neurologic outcomes. The levels of total cholesterol and HDL after ROSC were associated with good neurologic outcomes in patients with OHCA, without considering the effect of other lipid profiles simultaneously.