Clin Exp Emerg Med.  2017 Dec;4(4):232-237. 10.15441/ceem.16.164.

Admission levels of high-density lipoprotein and apolipoprotein A-1 are associated with the neurologic outcome in patients with out-of-hospital cardiac arrest

• Son YS
• Kim KS
• Suh GJ
• Kwon WY
• Park MJ
• Ko JI
• Kim T

• KMID: 2401233
• DOI: http://doi.org/10.15441/ceem.16.164

Abstract

OBJECTIVE
To investigate whether serum levels of high-density lipoprotein (HDL) and apolipoprotein A-1 (ApoA1), after the return of spontaneous circulation, can predict the neurologic outcome in patients with out-of-hospital cardiac arrest (OHCA).
METHODS
This was a retrospective observational study conducted in a single tertiary hospital intensive care unit. All adult OHCA survivors with admission lipid profiles were enrolled from March 2013 to December 2015. Good neurologic outcome was defined as discharge cerebral performance categories 1 and 2.
RESULTS
Among 59 patients enrolled, 13 (22.0%) had a good neurologic outcome. Serum levels of HDL (56.7 vs. 40 mg/dL) and ApoA1 (117 vs. 91.6 mg/dL) were significantly higher in patients with a good outcome. Areas under the HDL and ApoA1 receiver operating curves to predict good outcomes were 0.799 and 0.759, respectively. The proportion of good outcome was significantly higher in patients in higher tertiles of HDL and ApoA1 (test for trend, both P=0.003). HDL (P=0.018) was an independent predictor in the multivariate logistic regression model.
CONCLUSION
Admission levels of HDL and ApoA1 are associated with neurologic outcome in patients with OHCA. Prognostic and potential therapeutic values of HDL and ApoA1 merit further evaluation in the post-cardiac arrest state, as in other systemic inflammatory conditions such as sepsis.

Keyword

Heart arrest; Cholesterol, HDL; Apolipoprotein A-1; Prognosis

MeSH Terms

Adult
Apolipoprotein A-I*
Apolipoproteins*
Cholesterol, HDL
Heart Arrest
Humans
Intensive Care Units
Lipoproteins*
Logistic Models
Observational Study
Out-of-Hospital Cardiac Arrest*
Prognosis
Retrospective Studies
Sepsis
Survivors
Tertiary Care Centers
Apolipoprotein A-I
Apolipoproteins
Cholesterol, HDL
Lipoproteins