Plasma phosphorylated tau (p-tau231) and total tau (t-tau) as prognostic markers of neurological outcome after cardiac arrest - a multicentre study

Year: 2024

Type: article

Abstract: PURPOSE: We studied the promising Alzheimer biomarker plasma tau phosphorylated at threonine 231 (p-tau231) in a cohort of cardiac arrest patients who survived to intensive care to predict long-term neurological outcomes. We also compared it to total tau (t-tau), which has demonstrated predictive abilities of neurological outcome post-cardiac arrest. METHODS: This observational multicentre cohort study included 425 patients admitted to intensive care after cardiac arrest. Plasma p-tau231 was retrospectively analysed at admission, 12 and 48 h after cardiac arrest. The association of the Cerebral Performance Category (CPC) with p-tau231 was analysed with a one-way analysis of variance (ANOVA). CPC was modelled using multivariate ordinal logistic regression, and the biomarkers' prognostic performance was assessed by the area under the receiver operating characteristic curve (AUC). RESULTS: Increasing p-tau231 levels were significantly associated with worse CPC (p < 0.001). P-tau231 showed moderate prognostic abilities (AUC: 0.69 on admission, 0.72 at 12 h, and 0.71 at 48 h) for all patients but did not improve neurological prognostication after adjusting for clinical covariates. Elevated levels of t-tau were significantly associated with a worse outcome at all time points (p < 0.001). T-tau significantly improved neurological prognosis at 48 h after adjusting for covariates (AUC: 0.95, 95 % CI 0.93-0.98, p < 0.001) compared to the clinical covariate reference model (AUC: 0.88, 95 % CI 0.84-0.93). CONCLUSIONS: Although p-tau231 showed moderate neurological prognostic ability, t-tau was a stronger predictor, particularly at 48 h, even after adjusting for clinical covariates.

Source: Resuscitation

DOI: 10.1016/j.resuscitation.2024.110450

Authors: Bergþóra Þorgeirsdóttir, Theodor Sievert, Anna Lybeck, Nicholas J. Ashton, Kaj Blennow, Henrik Zetterberg, Hans Friberg, Attila Frigyesi

Institutions: Lund University, Skåne University Hospital, Sahlgrenska University Hospital, University of Gothenburg, University of Wisconsin–Madison, Pitié-Salpêtrière Hospital, UK Dementia Research Institute, Institut du Cerveau, UCL Queen Square Institute of Neurology, University College London

Language: English

Topic: Cardiac Arrest and Resuscitation

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,160

Funders: Alzheimer's Association, Henry Luce Foundation, EU Joint Programme – Neurodegenerative Disease Research, European Commission, Crafoordska Stiftelsen, Hjärnfonden, Hjärt-Lungfonden, Vetenskapsrådet, Medicinska Forskningsrådet, Kirsten og Freddy Johansens Fond, Alzheimerfonden, Region Skåne, Skånes universitetssjukhus, Fondation pour la Recherche sur Alzheimer

OpenAlex ID: W4404959993