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(Circulation. 2000;102:290.)
© 2000 American Heart Association, Inc.

Clinical Investigation and Reports

Elevation of Prostate-Specific Markers After Cardiopulmonary Resuscitation

Jeanette Koller-Strametz, MD; Monika Fritzer, MD; Marianne Gwechenberger, MD; Alexander Geppert, MD; Gottfried Heinz, MD; Markus Haumer, MD; Maria Koreny, MD; Gerald Maurer, MD; Peter Siostrzonek, MD

From the Department of Cardiology and Angiology, and the Clinical Institute for Medical and Chemical Laboratory Diagnostics (M.F.), University of Vienna, Austria.

Correspondence to Jeanette Koller-Strametz, MD, Department of Cardiology, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. E-mail jeanette.koller-strametz{at}univie.ac.at

Background—Prostate-specific antigen (PSA), acid phosphatase (AP), and prostatic acid phosphatase (PAP) are serum markers for adenocarcinoma of the prostate gland. Previous studies indicated that prostatic ischemia may also produce elevations of PSA. Cardiopulmonary resuscitation (CPR) is frequently associated with profound tissue hypoperfusion. The present study investigated whether PSA, AP, and PAP are influenced by prolonged CPR.

Methods and Results—PSA, AP, and PAP were assessed immediately, 12 hours, 24 hours, 2 days, 3 days, 5 days, and 7 days after prolonged CPR (>5 minutes) in 14 male and 5 female patients. No changes were noted in women. In men, serum levels increased significantly after CPR and gradually decreased to near baseline values after 7 days. PSA, AP, and PAP values above the normal range were observed in 63%, 71%, and 64% of all patients, respectively. Compared with survivors, nonsurvivors exhibited higher peak serum levels of PSA (98.6±14.3 versus 1.1±2.2 µg/L; P<0.03), AP (57.0±71 versus 8.6±8.8 U/L; P<0.05), and PAP (47.0±62 versus 5.7±8.0 U/L; P=NS). Patients with poor neurological outcome exhibited higher peak serum levels of PSA (86.4±135.5 versus 12.0±23.8 µg/L; P<0.05), AP (50.9±68.1 versus 8.7±9.6 U/L; P=NS), and PAP (41.6±59.5 versus 5.8±8.8 U/L; P=NS) than patients with good neurological outcome.

Conclusions—Prolonged CPR is frequently associated with increases of PSA, AP, and PAP serum levels. Therefore, PSA cannot be used for diagnosis of adenocarcinoma of the prostate during the first weeks after CPR. Further evaluation of these parameters as additional prognostic markers after CPR is warranted.

Key Words: antigens • cardiopulmonary resuscitation