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Association between the simultaneous decrease in the levels of soluble vascular cell adhesion molecule-1 and S100
Min-Jung Kim1, Taegyun Kim1, Gil Joon Suh1
1Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.
Insights
A simultaneous decrease in vascular cell adhesion molecule-1 (VCAM-1) and S100 protein levels within 24 hours of return of spontaneous circulation indicates good neurological outcomes in cardiac arrest survivors.
Area of Science:
- Neurology
- Cardiology
- Biochemistry
Background:
- Cardiac arrest survivors often experience neurological deficits.
- Early biomarkers are crucial for predicting neurological outcomes.
- Cell adhesion molecules and S100 proteins are implicated in post-cardiac arrest injury.
Purpose of the Study:
- To investigate the association between early serum levels of cell adhesion molecules (ICAM-1, VCAM-1, E-selectin) and S100 proteins and neurological outcomes in cardiac arrest survivors.
- To determine if simultaneous decreases in these markers predict good neurological recovery.
Main Methods:
- Retrospective observational study of 29 out-of-hospital cardiac arrest survivors.
- Blood samples collected at 0 and 24 hours post-ICU admission.
- Patients categorized into good (CPC 1-2) and poor (CPC 3-5) neurological outcome groups at 6 months.
Main Results:
- No significant difference in individual marker levels between outcome groups at 0 or 24 hours.
- A simultaneous decrease in vascular cell adhesion molecule-1 (VCAM-1) and S100 proteins was associated with good neurological outcomes.
- This simultaneous decrease remained an independent predictor of good neurological outcomes after adjustment for other variables (OR 9.285, P=0.043).
Conclusions:
- A simultaneous decline in serum VCAM-1 and S100 levels within 24 hours post-resuscitation is linked to favorable neurological outcomes.
- These markers may serve as early indicators of neurological recovery in cardiac arrest survivors.
Objective:
This study aimed to determine whether simultaneous decreases in the serum levels of cell adhesion molecules (intracellular cell adhesion molecule-1 [ICAM-1], vascular cell adhesion molecule-1 [VCAM-1], and E-selectin) and S100 proteins within the first 24 hours after the return of spontaneous circulation were associated with good neurological outcomes in cardiac arrest survivors.
Methods:
This retrospective observational study was based on prospectively collected data from a single emergency intensive care unit (ICU). Twenty-nine out-of-hospital cardiac arrest survivors who were admitted to the ICU for post-resuscitation care were enrolled. Blood samples were collected at 0 and 24 hours after ICU admission. According to the 6-month cerebral performance category (CPC) scale, the patients were divided into good (CPC 1 and 2, n=12) and poor (CPC 3 to 5, n=17) outcome groups.
Results:
No difference was observed between the two groups in terms of the serum levels of ICAM-1, VCAM-1, E-selectin, and S100 at 0 and 24 hours. A simultaneous decrease in the serum levels of VCAM-1 and S100 as well as E-selectin and S100 was associated with good neurological outcomes. When other variables were adjusted, a simultaneous decrease in the serum levels of VCAM-1 and S100 was independently associated with good neurological outcomes (odds ratio, 9.285; 95% confidence interval, 1.073 to 80.318; P=0.043).
Conclusion:
A simultaneous decrease in the serum levels of soluble VCAM-1 and S100 within the first 24 hours after the return of spontaneous circulation was associated with a good neurological outcome in out-of-hospital cardiac arrest survivors.
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