Cardiac arrest & resuscitation
Plasma glial fibrillary acidic protein and tau: predictors of neurological outcome after cardiac arrest
Authors' conclusion
GFAP and tau are promising biomarkers for neuroprognostication, with the highest predictive performance at 48 h after OHCA, but not superior to NFL. The predictive ability of GFAP may be sufficiently high for clinical use at 12 h after cardiac arrest.
Study context
- Population
- Patients admitted to intensive care unit (ICU) after OHCA or in-hospital cardiac arrest (IHCA), three hospitals in Sweden, 2014–2018328 OHCA, 100 IHCA
- Participants
- 428 patients
- Exposure
- Plasma glial fibrillary acidic protein (GFAP) and total-tau as predictors of poor neurological outcome, compared with neurofilament light (NFL) and neuron-specific enolase (NSE)
- Outcome
- Poor neurological outcome (Cerebral Performance Category 3-5); prognostic performance by AUC
- Follow-up
- 2-6 months after cardiac arrest
Methodological detailsmulticentre, observational
- Multicentre
- Observational
Main finding
As reported in the abstract
Prediction of poor neurological outcome (AUC) at ICU admission, 12 h and 48 h
| Group | AUC, OHCA, ICU admission (95% CI 0.70-0.82) | AUC, OHCA, 12 h (95% CI 0.81-0.90) | AUC, OHCA, 48 h (95% CI 0.87-0.96) | AUC, IHCA, ICU admission (95% CI 0.66-0.87) | AUC, IHCA, 12 h (95% CI 0.74-0.92) | AUC, IHCA, 48 h (95% CI 0.71-0.95) | AUC, OHCA, ICU admission (95% CI 0.66-0.79) | AUC, OHCA, 12 h (95% CI 0.69-0.81) | AUC, OHCA, 48 h (95% CI 0.89-0.96) | AUC, IHCA, ICU admission (95% CI 0.49-0.74) | AUC, IHCA, 12 h (95% CI 0.56-0.79) | AUC, IHCA, 48 h (95% CI 0.65-0.90) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GFAP | 0.76 | 0.86 | 0.91 | 0.77 | 0.83 | 0.83 | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract |
| Tau | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | 0.72 | 0.75 | 0.93 | 0.61 | 0.68 | 0.77 |
AUC, OHCA, ICU admission (95% CI 0.70-0.82)
GFAP0.76
Tau— not stated in the abstract
AUC, OHCA, 12 h (95% CI 0.81-0.90)
GFAP0.86
Tau— not stated in the abstract
AUC, OHCA, 48 h (95% CI 0.87-0.96)
GFAP0.91
Tau— not stated in the abstract
AUC, IHCA, ICU admission (95% CI 0.66-0.87)
GFAP0.77
Tau— not stated in the abstract
AUC, IHCA, 12 h (95% CI 0.74-0.92)
GFAP0.83
Tau— not stated in the abstract
AUC, IHCA, 48 h (95% CI 0.71-0.95)
GFAP0.83
Tau— not stated in the abstract
AUC, OHCA, ICU admission (95% CI 0.66-0.79)
GFAP— not stated in the abstract
Tau0.72
AUC, OHCA, 12 h (95% CI 0.69-0.81)
GFAP— not stated in the abstract
Tau0.75
AUC, OHCA, 48 h (95% CI 0.89-0.96)
GFAP— not stated in the abstract
Tau0.93
AUC, IHCA, ICU admission (95% CI 0.49-0.74)
GFAP— not stated in the abstract
Tau0.61
AUC, IHCA, 12 h (95% CI 0.56-0.79)
GFAP— not stated in the abstract
Tau0.68
AUC, IHCA, 48 h (95% CI 0.65-0.90)
GFAP— not stated in the abstract
Tau0.77
— not stated in the abstract
Observational data: associations, not effects.
Further findings
Adding change in biomarker levels between time points
- Did not improve predictive accuracy vs the last time point
GFAP and tau vs NSE at 48 h (subset of patients)
- GFAP at 12 h and 48 h and tau at 48 h offered similar predictive value as NSE at 48 h after both OHCA and IHCA
NFL vs GFAP and tau
- NFL predictive performance similar or superior to GFAP and tau at all time points after OHCA and IHCA
Original publication
Plasma glial fibrillary acidic protein and tau: predictors of neurological outcome after cardiac arrest. Crit Care. Published 9 April 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →