l-arginine, asymmetric and symmetric dimethylarginine for early outcome prediction in unselected cardiac arrest victims: a prospective cohort study
| العنوان: | l-arginine, asymmetric and symmetric dimethylarginine for early outcome prediction in unselected cardiac arrest victims: a prospective cohort study |
|---|---|
| المؤلفون: | Barbara Sandor, Beata Csiszar, Kalman Toth, Zsolt Marton, Janos Riba, Peter Csecsei, Robert Halmosi, Lajos Nagy, Peter Kenyeres, Tihamer Molnar |
| المصدر: | Internal and Emergency Medicine. 17:525-534 |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Multivariate analysis, Arginine, medicine.medical_treatment, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, law, Internal medicine, Internal Medicine, medicine, Humans, Prospective Studies, Cardiopulmonary resuscitation, Simplified Acute Physiology Score, Prospective cohort study, Aged, Receiver operating characteristic, business.industry, 030208 emergency & critical care medicine, Prognosis, Intensive care unit, Heart Arrest, chemistry, Emergency Medicine, Cardiology, Female, business, Asymmetric dimethylarginine, Biomarkers |
| الوصف: | Early prediction of the mortality, neurological outcome is clinically essential after successful cardiopulmonary resuscitation. To find a prognostic marker among unselected cardiac arrest survivors, we aimed to evaluate the alterations of the l-arginine pathway molecules in the early post-resuscitation care. We prospectively enrolled adult patients after successfully resuscitated in- or out-of-hospital cardiac arrest. Blood samples were drawn within 6, 24, and 72 post-cardiac arrest hours to measure asymmetric and symmetric dimethylarginine (ADMA and SDMA) and l-arginine plasma concentrations. We recorded Sequential Organ Failure Assessment, Simplified Acute Physiology Score, and Cerebral Performance Category scores. Endpoints were 72 h, intensive care unit, and 30-day mortality. Among 54 enrolled patients [median age: 67 (61–78) years, 48% male], the initial ADMA levels were significantly elevated in those who died within 72 h [0.88 (0.64–0.97) µmol/L vs. 0.55 (0.45–0.69) µmol/L, p = 0.001]. Based on receiver operator characteristic analysis (AUC = 0.723; p = 0.005) of initial ADMA for poor neurological outcome, the best cutoff was determined as > 0.65 µmol/L (sensitivity = 66.7%; specificity = 81.5%), while for 72 h mortality (AUC = 0.789; p = 0.001) as > 0.81 µmol/L (sensitivity = 71.0%; specificity = 87.5%). Based on multivariate analysis, initial ADMA (OR = 1.8 per 0.1 µmol/L increment; p = 0.002) was an independent predictor for 72 h mortality. Increased initial ADMA predicts 72 h mortality and poor neurological outcome among unselected cardiac arrest victims. |
| تدمد: | 1970-9366 1828-0447 |
| DOI: | 10.1007/s11739-021-02767-z |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c42bad844655dbfac40f408145291205 https://doi.org/10.1007/s11739-021-02767-z |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....c42bad844655dbfac40f408145291205 |
| قاعدة البيانات: | OpenAIRE |
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