Absolute blood levels and kinetics of neurofilament light (NFL) chains for neurological prognosis in comatose patients after cardiac arrest
Résumé
Introduction Despite current guidelines, the prognosis of comatose patients after cardiac arrest (CA) remains indeterminate in approximately 50% of patients. Neurofilament light (NFL) chain, a biomarker of neuronal injury, appears to be a promising tool with better prognostic value compared to neuron-specific enolase (NSE). However, further studies are required. The objective was to evaluate the prognostic value of absolute blood levels and kinetics of NFL measured at 24, 48 and 72 h after CA to predict outcome.
Methods A prospective study conducted at a tertiary CA center conducted between April 2023 and November 2024, including 67 comatose patients after CA with at least one blood NFL measurement. The primary outcome was neurological outcome according to the "best" modified Rankin scale (mRS) within 3 months, with a mRS 0-3 defining a good outcome.
Participants were 64 years old (IQR [53-75]), and 67% were male. 60% of them had out-of-hospital CA and 42% had an initial shockable rhythm. NFL levels were significantly higher in patients with unfavorable outcome compared to those with favorable outcome at each time point (24 h: 256.
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