Document Detail


Persistently elevated extracellular HSP70 (HSPA1A) level as an independent prognostic marker in post-cardiac-arrest patients.
MedLine Citation:
PMID:  23321917     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Predicting the prognosis of comatose, post-cardiac-arrest patients is a complex problem in clinical practice. There are several established methods to foretell neurological outcome; however, further prognostic markers are needed. HSP70 (HSPA1A), which increases rapidly in response to severe stress (among others after ischemic or hypoxic events), is a biomarker of cell damage in the ischemic brain and spinal cord. We hypothesized that HSP70 might be a reliable predictor of mortality in post-cardiac-arrest patients. The aim of this study was to analyze the role of extracellular HSP70 in the systemic inflammatory response over time, as well as the predictive value in cardiac arrest patients. Here, we show that the elevation of HSP70 levels in resuscitated patients and their persistence is an independent predictor of 30-day mortality after a cardiac arrest. Forty-six cardiac arrest patients were successfully cooled to 32-34 °C for 24 h, and followed up for 30 days. Twenty-four patients (52.2 %) were alive by the end of follow-up, and 22 patients (47.8 %) died. Forty-six patients with stable cardiovascular disease served as controls. Extracellular HSP70 (measured by ELISA in blood samples) was elevated in all resuscitated patients (1.31 [0.76-2.73] and 1.70 [1.20-2.37] ng/ml for survivors and non-survivors, respectively), compared with the controls (0.59 [0.44-0.83] ng/ml). HSP70 level decreased significantly in survivors, but persisted in non-survivors, and predicted 30-day mortality regardless of age, sex, complications, and the APACHE II score. Extracellular HSP70 could prove useful for estimating prognosis in comatose post-cardiac-arrest patients.
Authors:
Zsigmond M Jenei; Gábor Széplaki; Béla Merkely; István Karádi; Endre Zima; Zoltán Prohászka
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-01-16
Journal Detail:
Title:  Cell stress & chaperones     Volume:  18     ISSN:  1466-1268     ISO Abbreviation:  Cell Stress Chaperones     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-14     Completed Date:  2013-12-30     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  9610925     Medline TA:  Cell Stress Chaperones     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  447-54     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
APACHE
Aged
Biological Markers / blood
Body Temperature
Cardiopulmonary Resuscitation
Female
HSP70 Heat-Shock Proteins / blood*,  metabolism
Heart Arrest / blood*,  mortality,  pathology
Humans
Hypothermia, Induced
Kaplan-Meier Estimate
Male
Middle Aged
Prognosis
Chemical
Reg. No./Substance:
0/Biological Markers; 0/HSP70 Heat-Shock Proteins; 0/HSPA1A protein, human
Comments/Corrections

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