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Low PCSK-9 levels Are Associated with Favorable Neurologic Function after Resuscitation from out of Hospital Cardiac Arrest

Endotoxemia after cardiopulmonary resuscitation (CPR) is associated with unfavorable outcome. Proprotein convertase subtilisin/kexin type-9 (PCSK–9) regulates low-density lipoprotein receptors, which mediate the hepatic uptake of endotoxins. We hypothesized that PCSK–9 concentrations are associated...

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Autores principales: Merrelaar, Anne, Buchtele, Nina, Schriefl, Christoph, Clodi, Christian, Poppe, Michael, Ettl, Florian, Herkner, Harald, Jilma, Bernd, Schwameis, Michael, Schoergenhofer, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465607/
https://www.ncbi.nlm.nih.gov/pubmed/32796672
http://dx.doi.org/10.3390/jcm9082606
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author Merrelaar, Anne
Buchtele, Nina
Schriefl, Christoph
Clodi, Christian
Poppe, Michael
Ettl, Florian
Herkner, Harald
Jilma, Bernd
Schwameis, Michael
Schoergenhofer, Christian
author_facet Merrelaar, Anne
Buchtele, Nina
Schriefl, Christoph
Clodi, Christian
Poppe, Michael
Ettl, Florian
Herkner, Harald
Jilma, Bernd
Schwameis, Michael
Schoergenhofer, Christian
author_sort Merrelaar, Anne
collection PubMed
description Endotoxemia after cardiopulmonary resuscitation (CPR) is associated with unfavorable outcome. Proprotein convertase subtilisin/kexin type-9 (PCSK–9) regulates low-density lipoprotein receptors, which mediate the hepatic uptake of endotoxins. We hypothesized that PCSK–9 concentrations are associated with neurological outcome in patients after CPR. Successfully resuscitated out-of-hospital cardiac arrest patients were included prospectively (n = 79). PCSK–9 levels were measured on admission, 12 h and 24 h thereafter, and after rewarming. The primary outcome was favorable neurologic function at day 30, defined by cerebral performance categories (CPC 1–2 = favorable vs. CPC 3–5 = unfavorable). Receiver operating characteristic curve analysis was used to identify the PCSK–9 level cut-off for optimal discrimination between favorable and unfavorable 30-day neurologic function. Logistic regression models were calculated to estimate the effect of PCSK–9 levels on the primary outcome, given as odds ratio (OR) and 95% confidence interval (95%CI). PCSK–9 levels on admission were significantly lower in patients with favorable 30-day neurologic function (median 158 ng/mL, (quartiles: 124–225) vs. 207 ng/mL (174–259); p = 0.019). The optimally discriminating PCSK–9 level cut-off was 165 ng/mL. In patients with PCSK–9 levels ≥ 165 ng/mL, the odds of unfavorable neurological outcome were 4.7-fold higher compared to those with PCSK–9 levels < 165 ng/mL. In conclusion, low PCSK–9 levels were associated with favorable neurologic function.
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spelling pubmed-74656072020-09-04 Low PCSK-9 levels Are Associated with Favorable Neurologic Function after Resuscitation from out of Hospital Cardiac Arrest Merrelaar, Anne Buchtele, Nina Schriefl, Christoph Clodi, Christian Poppe, Michael Ettl, Florian Herkner, Harald Jilma, Bernd Schwameis, Michael Schoergenhofer, Christian J Clin Med Article Endotoxemia after cardiopulmonary resuscitation (CPR) is associated with unfavorable outcome. Proprotein convertase subtilisin/kexin type-9 (PCSK–9) regulates low-density lipoprotein receptors, which mediate the hepatic uptake of endotoxins. We hypothesized that PCSK–9 concentrations are associated with neurological outcome in patients after CPR. Successfully resuscitated out-of-hospital cardiac arrest patients were included prospectively (n = 79). PCSK–9 levels were measured on admission, 12 h and 24 h thereafter, and after rewarming. The primary outcome was favorable neurologic function at day 30, defined by cerebral performance categories (CPC 1–2 = favorable vs. CPC 3–5 = unfavorable). Receiver operating characteristic curve analysis was used to identify the PCSK–9 level cut-off for optimal discrimination between favorable and unfavorable 30-day neurologic function. Logistic regression models were calculated to estimate the effect of PCSK–9 levels on the primary outcome, given as odds ratio (OR) and 95% confidence interval (95%CI). PCSK–9 levels on admission were significantly lower in patients with favorable 30-day neurologic function (median 158 ng/mL, (quartiles: 124–225) vs. 207 ng/mL (174–259); p = 0.019). The optimally discriminating PCSK–9 level cut-off was 165 ng/mL. In patients with PCSK–9 levels ≥ 165 ng/mL, the odds of unfavorable neurological outcome were 4.7-fold higher compared to those with PCSK–9 levels < 165 ng/mL. In conclusion, low PCSK–9 levels were associated with favorable neurologic function. MDPI 2020-08-11 /pmc/articles/PMC7465607/ /pubmed/32796672 http://dx.doi.org/10.3390/jcm9082606 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Merrelaar, Anne
Buchtele, Nina
Schriefl, Christoph
Clodi, Christian
Poppe, Michael
Ettl, Florian
Herkner, Harald
Jilma, Bernd
Schwameis, Michael
Schoergenhofer, Christian
Low PCSK-9 levels Are Associated with Favorable Neurologic Function after Resuscitation from out of Hospital Cardiac Arrest
title Low PCSK-9 levels Are Associated with Favorable Neurologic Function after Resuscitation from out of Hospital Cardiac Arrest
title_full Low PCSK-9 levels Are Associated with Favorable Neurologic Function after Resuscitation from out of Hospital Cardiac Arrest
title_fullStr Low PCSK-9 levels Are Associated with Favorable Neurologic Function after Resuscitation from out of Hospital Cardiac Arrest
title_full_unstemmed Low PCSK-9 levels Are Associated with Favorable Neurologic Function after Resuscitation from out of Hospital Cardiac Arrest
title_short Low PCSK-9 levels Are Associated with Favorable Neurologic Function after Resuscitation from out of Hospital Cardiac Arrest
title_sort low pcsk-9 levels are associated with favorable neurologic function after resuscitation from out of hospital cardiac arrest
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465607/
https://www.ncbi.nlm.nih.gov/pubmed/32796672
http://dx.doi.org/10.3390/jcm9082606
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