Admission levels of high-density lipoprotein and apolipoprotein A-1 are associated with the neurologic outcome in patients with out-of-hospital cardiac arrest
To investigate whether serum levels of high-density lipoprotein (HDL) and apolipoprotein A-1 (ApoA1), after the return of spontaneous circulation, can predict the neurologic outcome in patients with out-of-hospital cardiac arrest (OHCA). This was a retrospective observational study conducted in a si...
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| Published in | Clinical and experimental emergency medicine Vol. 4; no. 4; pp. 232 - 237 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Korea (South)
The Korean Society of Emergency Medicine
01.12.2017
대한응급의학회 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2383-4625 2383-4625 |
| DOI | 10.15441/ceem.16.164 |
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| Abstract | To investigate whether serum levels of high-density lipoprotein (HDL) and apolipoprotein A-1 (ApoA1), after the return of spontaneous circulation, can predict the neurologic outcome in patients with out-of-hospital cardiac arrest (OHCA).
This was a retrospective observational study conducted in a single tertiary hospital intensive care unit. All adult OHCA survivors with admission lipid profiles were enrolled from March 2013 to December 2015. Good neurologic outcome was defined as discharge cerebral performance categories 1 and 2.
Among 59 patients enrolled, 13 (22.0%) had a good neurologic outcome. Serum levels of HDL (56.7 vs. 40 mg/dL) and ApoA1 (117 vs. 91.6 mg/dL) were significantly higher in patients with a good outcome. Areas under the HDL and ApoA1 receiver operating curves to predict good outcomes were 0.799 and 0.759, respectively. The proportion of good outcome was significantly higher in patients in higher tertiles of HDL and ApoA1 (test for trend, both P=0.003). HDL (P=0.018) was an independent predictor in the multivariate logistic regression model.
Admission levels of HDL and ApoA1 are associated with neurologic outcome in patients with OHCA. Prognostic and potential therapeutic values of HDL and ApoA1 merit further evaluation in the post-cardiac arrest state, as in other systemic inflammatory conditions such as sepsis. |
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| AbstractList | Objective To investigate whether serum levels of high-density lipoprotein (HDL) and apolipoprotein A-1 (ApoA1), after the return of spontaneous circulation, can predict the neurologic outcome in patients with out-of-hospital cardiac arrest (OHCA). Methods This was a retrospective observational study conducted in a single tertiary hospital intensive care unit. All adult OHCA survivors with admission lipid profiles were enrolled from March 2013 to December 2015. Good neurologic outcome was defined as discharge cerebral performance categories 1 and 2. Results Among 59 patients enrolled, 13 (22.0%) had a good neurologic outcome. Serum levels of HDL (56.7 vs. 40 mg/dL) and ApoA1 (117 vs. 91.6 mg/dL) were significantly higher in patients with a good outcome. Areas under the HDL and ApoA1 receiver operating curves to predict good outcomes were 0.799 and 0.759, respectively. The proportion of good outcome was significantly higher in patients in higher tertiles of HDL and ApoA1 (test for trend, both P=0.003). HDL (P=0.018) was an independent predictor in the multivariate logistic regression model. Conclusion Admission levels of HDL and ApoA1 are associated with neurologic outcome in patients with OHCA. Prognostic and potential therapeutic values of HDL and ApoA1 merit further evaluation in the post-cardiac arrest state, as in other systemic inflammatory conditions such as sepsis. Objective To investigate whether serum levels of high-density lipoprotein (HDL) and apolipoprotein A-1 (ApoA1), after the return of spontaneous circulation, can predict the neurologic outcome in patients with out-of-hospital cardiac arrest (OHCA). Methods This was a retrospective observational study conducted in a single tertiary hospital intensive care unit. All adult OHCA survivors with admission lipid profiles were enrolled from March 2013 to December 2015. Good neurologic outcome was defined as discharge cerebral performance categories 1 and 2. Results Among 59 patients enrolled, 13 (22.0%) had a good neurologic outcome. Serum levels of HDL (56.7 vs. 40 mg/dL) and ApoA1 (117 vs. 91.6 mg/dL) were significantly higher in patients with a good outcome. Areas under the HDL and ApoA1 receiver operating curves to predict good outcomes were 0.799 and 0.759, respectively. The proportion of good outcome was significantly higher in patients in higher tertiles of HDL and ApoA1 (test for trend, both P=0.003). HDL (P=0.018) was an independent predictor in the multivariate logistic regression model. Conclusion Admission levels of HDL and ApoA1 are associated with neurologic outcome in patients with OHCA. Prognostic and potential therapeutic values of HDL and ApoA1 merit further evaluation in the post-cardiac arrest state, as in other systemic inflammatory conditions such as sepsis. KCI Citation Count: 0 To investigate whether serum levels of high-density lipoprotein (HDL) and apolipoprotein A-1 (ApoA1), after the return of spontaneous circulation, can predict the neurologic outcome in patients with out-of-hospital cardiac arrest (OHCA).OBJECTIVETo investigate whether serum levels of high-density lipoprotein (HDL) and apolipoprotein A-1 (ApoA1), after the return of spontaneous circulation, can predict the neurologic outcome in patients with out-of-hospital cardiac arrest (OHCA).This was a retrospective observational study conducted in a single tertiary hospital intensive care unit. All adult OHCA survivors with admission lipid profiles were enrolled from March 2013 to December 2015. Good neurologic outcome was defined as discharge cerebral performance categories 1 and 2.METHODSThis was a retrospective observational study conducted in a single tertiary hospital intensive care unit. All adult OHCA survivors with admission lipid profiles were enrolled from March 2013 to December 2015. Good neurologic outcome was defined as discharge cerebral performance categories 1 and 2.Among 59 patients enrolled, 13 (22.0%) had a good neurologic outcome. Serum levels of HDL (56.7 vs. 40 mg/dL) and ApoA1 (117 vs. 91.6 mg/dL) were significantly higher in patients with a good outcome. Areas under the HDL and ApoA1 receiver operating curves to predict good outcomes were 0.799 and 0.759, respectively. The proportion of good outcome was significantly higher in patients in higher tertiles of HDL and ApoA1 (test for trend, both P=0.003). HDL (P=0.018) was an independent predictor in the multivariate logistic regression model.RESULTSAmong 59 patients enrolled, 13 (22.0%) had a good neurologic outcome. Serum levels of HDL (56.7 vs. 40 mg/dL) and ApoA1 (117 vs. 91.6 mg/dL) were significantly higher in patients with a good outcome. Areas under the HDL and ApoA1 receiver operating curves to predict good outcomes were 0.799 and 0.759, respectively. The proportion of good outcome was significantly higher in patients in higher tertiles of HDL and ApoA1 (test for trend, both P=0.003). HDL (P=0.018) was an independent predictor in the multivariate logistic regression model.Admission levels of HDL and ApoA1 are associated with neurologic outcome in patients with OHCA. Prognostic and potential therapeutic values of HDL and ApoA1 merit further evaluation in the post-cardiac arrest state, as in other systemic inflammatory conditions such as sepsis.CONCLUSIONAdmission levels of HDL and ApoA1 are associated with neurologic outcome in patients with OHCA. Prognostic and potential therapeutic values of HDL and ApoA1 merit further evaluation in the post-cardiac arrest state, as in other systemic inflammatory conditions such as sepsis. To investigate whether serum levels of high-density lipoprotein (HDL) and apolipoprotein A-1 (ApoA1), after the return of spontaneous circulation, can predict the neurologic outcome in patients with out-of-hospital cardiac arrest (OHCA). This was a retrospective observational study conducted in a single tertiary hospital intensive care unit. All adult OHCA survivors with admission lipid profiles were enrolled from March 2013 to December 2015. Good neurologic outcome was defined as discharge cerebral performance categories 1 and 2. Among 59 patients enrolled, 13 (22.0%) had a good neurologic outcome. Serum levels of HDL (56.7 vs. 40 mg/dL) and ApoA1 (117 vs. 91.6 mg/dL) were significantly higher in patients with a good outcome. Areas under the HDL and ApoA1 receiver operating curves to predict good outcomes were 0.799 and 0.759, respectively. The proportion of good outcome was significantly higher in patients in higher tertiles of HDL and ApoA1 (test for trend, both P=0.003). HDL (P=0.018) was an independent predictor in the multivariate logistic regression model. Admission levels of HDL and ApoA1 are associated with neurologic outcome in patients with OHCA. Prognostic and potential therapeutic values of HDL and ApoA1 merit further evaluation in the post-cardiac arrest state, as in other systemic inflammatory conditions such as sepsis. |
| Author | Suh, Gil Joon Kwon, Woon Yong Son, Yong Soo Kim, Taegyun Ko, Jung In Kim, Kyung Su Park, Min Ji |
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| CitedBy_id | crossref_primary_10_1016_j_resuscitation_2019_10_005 crossref_primary_10_1016_j_resuscitation_2019_11_003 crossref_primary_10_1097_MD_0000000000031909 crossref_primary_10_3390_ijms221910517 crossref_primary_10_1007_s11739_024_03742_0 crossref_primary_10_15441_ceem_20_114 crossref_primary_10_1016_j_ajem_2024_06_029 crossref_primary_10_3390_jpm12111787 |
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| Keywords | Heart arrest Prognosis Cholesterol, HDL Apolipoprotein A-1 |
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| References_xml | – start-page: 88 volume-title: Serum levels of apolipoprotein A-I and high-density lipoprotein can predict organ failure in acute pancreatitis year: 2015 ident: ref8 – volume-title: CARES summary report: demographic and survival characteristics of OHCA [Internet] year: 2014 ident: ref1 – start-page: 1359 volume-title: Lipoprotein metabolism in patients with severe sepsis year: 2003 ident: ref6 – start-page: 1563 volume-title: Relationship of hypolipidemia to cytokine concentrations and outcomes in critically ill surgical patients year: 2001 ident: ref9 – start-page: 2597 volume-title: High level of endotoxemia following out-of-hospital cardiac arrest is associated with severity and duration of postcardiac arrest shock year: 2015 ident: ref13 – start-page: 1576 volume-title: 4F, apolipoprotein AI mimetic peptide, attenuates acute lung injury and improves survival in endotoxemic rats year: 2012 ident: ref19 – start-page: 2821 volume-title: Distribution and kinetics of lipoprotein-bound endotoxin year: 2001 ident: ref11 – start-page: 1492 volume-title: Multiple organ dysfunction after return of spontaneous circulation in postcardiac arrest syndrome year: 2013 ident: ref3 – start-page: 5140 volume-title: Prevention of endotoxin-induced monokine release by human low- and high-density lipoproteins and by apolipoprotein A-I year: 1993 ident: ref12 – start-page: 562 volume-title: Successful cardiopulmonary resuscitation after cardiac arrest as a “sepsis-like” syndrome year: 2002 ident: ref4 – start-page: 8 volume-title: Cytokines decrease apolipoprotein accumulation in medium from Hep G2 cells year: 1994 ident: ref15 – start-page: 359 volume-title: Association of serum tumor necrosis factor levels with decrease of cholesterol during septic shock year: 1998 ident: ref14 – start-page: 61 volume-title: Functional outcome in young adult ischemic stroke: impact of lipoproteins year: 2013 ident: ref17 – start-page: 244 volume-title: HDL in sepsis: risk factor and therapeutic approach year: 2015 ident: ref20 – start-page: 32 volume-title: Cardiopulmonary resuscitation outcome of out-of-hospital cardiac arrest in low-volume versus high-volume emergency departments: an observational study and propensity score matching analysis year: 2011 ident: ref2 – start-page: 1688 volume-title: Low serum level of highdensity lipoprotein cholesterol is a poor prognostic factor for severe sepsis year: 2005 ident: ref7 – start-page: 2839 volume-title: Association of apolipoprotein A1 and B with kidney function and chronic kidney disease in two multiethnic population samples year: 2012 ident: ref21 – start-page: 2895 volume-title: Significance of arterial hypotension after resuscitation from cardiac arrest year: 2009 ident: ref16 – start-page: S768 volume-title: Part 9: postcardiac arrest care: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care year: 2010 ident: ref10 – start-page: 776 volume-title: Clinical utility of different lipid measures for prediction of coronary heart disease in men and women year: 2007 ident: ref5 – start-page: 820 volume-title: Proteomics of cerebral injury in a neonatal model of cardiopulmonary bypass with deep hypothermic circulatory arrest year: 2006 ident: ref18 |
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| SubjectTerms | apolipoprotein a-1 cholesterol, hdl heart arrest Original prognosis 응급의학 |
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| Title | Admission levels of high-density lipoprotein and apolipoprotein A-1 are associated with the neurologic outcome in patients with out-of-hospital cardiac arrest |
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