Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.
Medicine (Baltimore). 2024 Jul 5;103(27):e38772. doi: 10.1097/MD.0000000000038772.
Free fatty acids (FFA) are a known risk factor in the development of sudden cardiac death. However, the relationship between FFA and the outcome of out-of-hospital cardiac arrest (OHCA) patients remains unclear. We aimed to examine the association between FFA and neurological outcomes in OHCA patients. This prospective observational study included adult (≥18 years) OHCA patients between February 2016 and December 2022. We measured serial FFA levels within 1 hour after ROSC and at 6, 12, 24, 48, and 72 hours after the return of spontaneous circulation (ROSC). The primary outcome was neurological outcome at 6 months. A poor neurological outcome was defined by cerebral performance categories 3, 4, and 5. A total of 147 patients were included. Of them, 104 (70.7%) had poor neurological outcomes, whereby the median FFA levels within 1 hour after ROSC (0.72 vs 1.01 mol/L), at 6 hours (1.19 vs 1.90 mol/L), 12 hours (1.20 vs 1.66 mol/L), and 24 hours (1.20 vs 1.95 mol/L) after ROSC were significantly lower than in good outcome group. The FFA levels at 6 hours (odds ratio, 0.583; 95% confidence interval, 0.370-0.919; P = .020), and 12 hours (odds ratio, 0.509; 95% confidence interval, 0.303-0.854; P = .011) after ROSC were independently associated with poor neurological outcomes. The lower FFA levels at 6 hours and 12 hours after ROSC were associated with poor neurological outcomes in patients with OHCA. FFA may reflect oxidative metabolism as well as oxidative stress.
游离脂肪酸（FFA）是突发心源性死亡发展的已知危险因素。然而，FFA 与院外心脏骤停（OHCA）患者结局之间的关系尚不清楚。我们旨在研究 FFA 与 OHCA 患者神经结局之间的关系。这项前瞻性观察性研究纳入了 2016 年 2 月至 2022 年 12 月期间的成年（≥18 岁）OHCA 患者。我们在 ROSC 后 1 小时内以及自主循环恢复（ROSC）后 6、12、24、48 和 72 小时测量了连续的 FFA 水平。主要结局是 6 个月时的神经结局。神经结局差定义为脑功能分类 3、4 和 5 级。共纳入 147 例患者，其中 104 例（70.7%）神经结局差，ROSC 后 1 小时内（0.72 比 1.01mmol/L）、6 小时（1.19 比 1.90mmol/L）、12 小时（1.20 比 1.66mmol/L）和 24 小时（1.20 比 1.95mmol/L）FFA 水平明显低于神经结局好的组。ROSC 后 6 小时（优势比，0.583；95%置信区间，0.370-0.919；P=0.020）和 12 小时（优势比，0.509；95%置信区间，0.303-0.854；P=0.011）FFA 水平与神经结局差独立相关。ROSC 后 6 小时和 12 小时的 FFA 水平较低与 OHCA 患者的神经结局差相关。FFA 可能反映氧化代谢和氧化应激。
