Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria.
Department of Anaesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University of Salzburg, Salzburg, Austria.
Sci Rep. 2021 Nov 5;11(1):21756. doi: 10.1038/s41598-021-01389-x.
Prognostication after cardiopulmonary resuscitation (CPR) is complex. Novel biomarkers like soluble suppression of tumorigenicity 2 (sST2) may provide an objective approach. A total of 106 post-CPR patients were included in this single-center observational prospective study. Serum sST2 levels were obtained 24 h after admission. Individuals were assigned to two groups: patients below and above the overall cohort's median sST2 concentration. Primary outcome was a combined endpoint at 6 months (death or Cerebral Performance Category > 2); secondary endpoint 30-day mortality. A uni- and multivariate logistic regression analysis were conducted. Elevated sST2-levels were associated with an increased risk for the primary outcome (OR 1.011, 95% CI 1.004-1.019, p = 0.004), yet no patients with poor neurological outcome were observed at 6 months. The optimal empirical cut-off for sST2 was 46.15 ng/ml (sensitivity 81%, specificity 53%, AUC 0.69). Levels above the median (> 53.42 ng/ml) were associated with higher odds for both endpoints (death or CPC > 2 after 6 months: 21% vs. 49%, OR 3.59, 95% CI 1.53-8.45, p = 0.003; death after 30 days: 17% vs. 43.3%, OR 3.75, 95% CI 1.52-9.21, p = 0.003). A positive correlation of serum sST2 after CPR with mortality at 30 days and 6 months after cardiac arrest could be demonstrated.
心肺复苏（CPR）后预后评估较为复杂。新型生物标志物如可溶性抑瘤素 2（sST2）可能提供一种客观的方法。本单中心前瞻性观察研究共纳入 106 例 CPR 后患者。入院后 24 小时内获得血清 sST2 水平。将患者分为两组：sST2 浓度低于和高于整个队列中位数。主要终点为 6 个月时的复合终点（死亡或脑功能预后分类>2 级）；次要终点为 30 天死亡率。进行了单变量和多变量逻辑回归分析。sST2 水平升高与主要终点风险增加相关（OR 1.011，95%CI 1.004-1.019，p=0.004），但 6 个月时无患者出现不良神经结局。sST2 的最佳经验截断值为 46.15ng/ml（灵敏度 81%，特异性 53%，AUC 0.69）。中位数以上（>53.42ng/ml）的水平与两个终点（6 个月后死亡或 CPC>2：21%比 49%，OR 3.59，95%CI 1.53-8.45，p=0.003；30 天后死亡：17%比 43.3%，OR 3.75，95%CI 1.52-9.21，p=0.003）的可能性更高。CPR 后血清 sST2 与心脏骤停后 30 天和 6 个月的死亡率呈正相关。
