Biomarkers of brain injury after cardiac arrest; a statistical analysis plan from the TTM2 trial biobank investigators.

Brain injury markers Cardiac arrest GFAP, S100 NFL NSE Neurofilament light Neuron specific enolase Prognostication, outcome, biomarkers Protocol Total-tau, glial fibrially acidic protein

Journal

Resuscitation plus
ISSN: 2666-5204
Titre abrégé: Resusc Plus
Pays: Netherlands
ID NLM: 101774410

Informations de publication

Date de publication:
Jun 2022
Historique:
received: 09 05 2022
revised: 23 05 2022
accepted: 23 05 2022
entrez: 9 6 2022
pubmed: 10 6 2022
medline: 10 6 2022
Statut: epublish

Résumé

Several biochemical markers in blood correlate with the magnitude of brain injury and may be used to predict neurological outcome after cardiac arrest. We present a protocol for the evaluation of prognostic accuracy of brain injury markers after cardiac arrest. The aim is to define the best predictive marker and to establish clinically useful cut-off levels for routine implementation. Prospective international multicenter trial within the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial in collaboration with Roche Diagnostics International AG. Samples were collected 0, 24, 48, and 72 hours after randomisation (serum) and 0 and 48 hours after randomisation (plasma), and pre-analytically processed at each site before storage in a central biobank. Routine markers neuron-specific enolase (NSE) and S100B, and neurofilament light, total-tau and glial fibrillary acidic protein will be batch analysed using novel Elecsys® electrochemiluminescence immunoassays on a Cobas e601 instrument. Statistical analysis will be reported according to the Standards for Reporting Diagnostic accuracy studies (STARD) and will include comparisons for prediction of good versus poor functional outcome at six months post-arrest, by modified Rankin Scale (0-3 vs. 4-6), using logistic regression models and receiver operating characteristics curves, evaluation of mortality at six months according to biomarker levels and establishment of cut-off values for prediction of poor neurological outcome at 95-100% specificities. This prospective trial may establish a standard methodology and clinically appropriate cut-off levels for the optimal biomarker of brain injury which predicts poor neurological outcome after cardiac arrest.

Sections du résumé

Background UNASSIGNED
Several biochemical markers in blood correlate with the magnitude of brain injury and may be used to predict neurological outcome after cardiac arrest. We present a protocol for the evaluation of prognostic accuracy of brain injury markers after cardiac arrest. The aim is to define the best predictive marker and to establish clinically useful cut-off levels for routine implementation.
Methods UNASSIGNED
Prospective international multicenter trial within the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial in collaboration with Roche Diagnostics International AG. Samples were collected 0, 24, 48, and 72 hours after randomisation (serum) and 0 and 48 hours after randomisation (plasma), and pre-analytically processed at each site before storage in a central biobank. Routine markers neuron-specific enolase (NSE) and S100B, and neurofilament light, total-tau and glial fibrillary acidic protein will be batch analysed using novel Elecsys® electrochemiluminescence immunoassays on a Cobas e601 instrument.
Results UNASSIGNED
Statistical analysis will be reported according to the Standards for Reporting Diagnostic accuracy studies (STARD) and will include comparisons for prediction of good versus poor functional outcome at six months post-arrest, by modified Rankin Scale (0-3 vs. 4-6), using logistic regression models and receiver operating characteristics curves, evaluation of mortality at six months according to biomarker levels and establishment of cut-off values for prediction of poor neurological outcome at 95-100% specificities.
Conclusions UNASSIGNED
This prospective trial may establish a standard methodology and clinically appropriate cut-off levels for the optimal biomarker of brain injury which predicts poor neurological outcome after cardiac arrest.

Identifiants

pubmed: 35677835
doi: 10.1016/j.resplu.2022.100258
pii: S2666-5204(22)00058-3
pmc: PMC9168690
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100258

Informations de copyright

© 2022 The Authors.

Références

Resuscitation. 2020 May;150:104-112
pubmed: 32205155
BMC Med. 2013 Feb 25;11:50
pubmed: 23432764
Crit Care Resusc. 2017 Jun;19(2):99-100
pubmed: 28651502
N Engl J Med. 2013 Dec 5;369(23):2197-206
pubmed: 24237006
Intensive Care Med. 2020 Oct;46(10):1803-1851
pubmed: 32915254
Crit Care. 2017 Jun 20;21(1):153
pubmed: 28629472
Intensive Care Med. 2021 Sep;47(9):984-994
pubmed: 34417831
Resuscitation. 2020 Sep;154:61-68
pubmed: 32445783
N Engl J Med. 2021 Jun 17;384(24):2283-2294
pubmed: 34133859
Acta Anaesthesiol Scand. 2017 Nov;61(10):1345-1353
pubmed: 28901546
Lancet Neurol. 2018 Sep;17(9):782-789
pubmed: 30054151
JAMA Neurol. 2019 Jan 1;76(1):64-71
pubmed: 30383090
PLoS One. 2018 Jul 6;13(7):e0200088
pubmed: 29979722
Ann Neurol. 2017 Nov;82(5):665-675
pubmed: 28981963
J Am Coll Cardiol. 2015 May 19;65(19):2104-14
pubmed: 25975474
Resuscitation. 2020 Nov;156:273-276
pubmed: 32946983
Intensive Care Med. 2021 Jan;47(1):39-48
pubmed: 32852582
Am Heart J. 2019 Nov;217:23-31
pubmed: 31473324
Resuscitation. 2021 Apr;161:220-269
pubmed: 33773827
Ann Intern Med. 2015 May 19;162(10):735-6
pubmed: 25984857
BMJ Open. 2016 Nov 14;6(11):e012799
pubmed: 28137831
Crit Care Med. 2017 Jul;45(7):1145-1151
pubmed: 28426467

Auteurs

Marion Moseby-Knappe (M)

Department of Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden.

Helena Levin (H)

Department of Clinical Sciences Lund, Anaesthesiology and Intensive Care, Research and Education, Lund University, Skåne University Hospital, Lund, Sweden.

Kaj Blennow (K)

Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden.
Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.

Susann Ullén (S)

Clinical Studies Sweden - Forum South, Skåne University Hospital, Lund, Sweden.

Henrik Zetterberg (H)

Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden.
Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, United Kingdom.
UK Dementia Research Institute at UCL, London, United Kingdom.
Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China.

Gisela Lilja (G)

Department of Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden.

Josef Dankiewicz (J)

Department of Clinical Sciences Lund, Cardiology, Lund University, Skåne University Hospital, Lund, Sweden.

Janus Christian Jakobsen (JC)

The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Denmark.
Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Denmark.

Alice Lagebrant (A)

Department of Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden.

Hans Friberg (H)

Department of Clinical Sciences Lund, Anaesthesia and Intensive Care, Lund University, Skåne University Hospital, Malmö, Sweden.

Alistair Nichol (A)

University College Dublin, Clinical Research Centre, St Vincent's University Hospital Dublin, Ireland.
The Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne. Australia.
Intensive Care Unit, Alfred Hospital, Melbourne, Australia.

Kate Ainschough (K)

University College Dublin, Clinical Research Centre, St Vincent's University Hospital Dublin, Ireland.

Glenn M Eastwood (GM)

Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia.
Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Matt P Wise (MP)

Adult Critical Care, University Hospital of Wales, Cardiff, United Kingdom.

Matthew Thomas (M)

Intensive Care Unit, University Hospitals, Bristol and Weston, England, United Kingdom.

Thomas Keeble (T)

Essex Cardiothoracic Centre, MSE, Basildon, Essex, United Kingdom.
MTRC, Anglia Ruskin School of Medicine, Chelmsford, Essex, United Kingdom.

Alain Cariou (A)

Medical Intensive Care Unit, AP-HP, Cochin Hospital, Paris, France, Paris Cité University, Paris, France.

Christoph Leithner (C)

AG Emergency and Critical Care Neurology, Campus Virchow Klinikum, Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany.

Christian Rylander (C)

Anaesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Joachim Düring (J)

Department of Clinical Sciences Lund, Anaesthesia and Intensive Care, Lund University, Skåne University Hospital, Malmö, Sweden.

Jan Bělohlávek (J)

Second Department of Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.

Anders Grejs (A)

Department of Anaesthesiology and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

Ola Borgquist (O)

Department of Clinical Sciences Lund, Anaesthesia and Intensive Care, Lund University, Department of Cardiothoracic Surgery, Skåne University Hospital, Lund, Sweden.

Johan Undén (J)

Department of Clinical Sciences Malmö, Dept. Operation and Intensive Care, Lund University, Hallands Hospital Halmstad, Halmstad, Sweden.

Maryline Simon (M)

Clinical Development Department, Roche Diagnostics International AG, Rotkreuz, Switzerland.

Vinzent Rolny (V)

Biostatistical Department, Roche Diagnostics International AG, Rotkreuz, Switzerland.

Alex Piehler (A)

Biostatistical Department, Roche Diagnostics International AG, Rotkreuz, Switzerland.

Tobias Cronberg (T)

Department of Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden.

Niklas Nielsen (N)

Department of Clinical Sciences Lund, Anaesthesia and Intensive Care, Lund University, Helsingborg Hospital, Lund, Sweden.

Classifications MeSH