Abstract 119: Circulating Oxidative Markers LOX-1 is an Independent Predictor for Survival to Hospital Discharge in Cardiac Arrest Patients
Purpose: Oxidative stress during cardiac arrest increases cellular damage and correlates with survival and poor neurological outcome. The aim of the study was to investigate whether circulating oxidative stress biomarkers, including malondialdehyde-low density lipoprotein (MDA-LDL) and serum lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) could be novel markers for cardiac arrest patients to predict survival outcome.
Methods and Results: A total of 87 cardiac arrest patients with return of spontaneous circulation were enrolled in the study. The mean age was 73.2±14.3 years old and 38% (33/87) survived to hospital discharge. Serum LOX-1 level within 2 hours after cardiac arrest was higher in non-survival group than in survival group (median level, 2.92 ng/ml [IQR 1.76-4.82] vs. 2.17 ng/ml [IQR 1.47-2.88], p<0.05 by Mann-Whitney test), but no significant difference in MDA-LDL level.
There were 59 patients survived more than 24 hours. LOX-1 levels was significantly higher in non-survival group (median LOX-1 level, 2.45 ng/ml [IQR 1.24-4.28] vs. 1.70 ng/ml [IQR 1.20-2.30], p<0.05). The MDA-LDL levels could be detected more in the non-survival group compared to survival group (20.7% vs. 3.3%, p<0.05).
The predictive capacity of area under the curve for LOX-1 at 2 hours and 24 hours for cardiac arrest were 0.63 (95% CI 0.51-0.75) and 0.67 (95% CI 0.52-0.81).
LOX-1 at 2nd hour was an independent predictor in a multivariate analysis (odds ratio, 2.28; 95% confidence interval, 1.18-4.43, p< 0.05). When combining the LOX-1 level with clinical factor of Apache II score, the patients with higher LOX-1 levels at 2 hours and higher APACHE II had significantly greater mortality rate compared with other groups (p< 0.05 by log-rank test).
Conclusion: The LOX-1 levels within 2 hrs and 24 hrs after cardiac arrest are independent factors for in-hospital mortality. It can further improve prognosis prediction when adding to APACHE II score. Hence, LOX-1 could be a useful biomarker for mortality prediction in cardiac arrest.
- © 2013 by American Heart Association, Inc.