ArticleNeurocritical care2017
Elevated Serum Glial Fibrillary Acidic Protein (GFAP) is Associated with Poor Functional Outcome After Cardiopulmonary Resuscitation.
Article in Neurocritical care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- GFAP and UCHL1 in Non-traumatic SAH: The Story thus Far. A Systematic Review of the Literature.CNS & neurological disorders drug targets · 2024Pooled it
- 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 5. Post-cardiac arrest care.Clinical and experimental emergency medicine · 2021Guideline
- Prediction of poor neurological outcome in comatose survivors of cardiac arrest: a systematic review.Intensive care medicine · 2020Pooled it
- Brain neurovascular unit biomarkers: a hypothesis-driven paradigm to advance understanding of post-cardiac arrest cerebral injury.Annals of intensive care · 2026Review
- Proteomic analysis of serum samples after cardiac arrest: Rationale and design of a TTM-trial substudy.Resuscitation plus · 2025Article
- Serum glial fibrillary acidic protein and protein gene product 9.5 for predicting neurological outcomes in cardiac arrest patients with cortical response to somatosensory evoked potentials.Resuscitation plus · 2025Article
- Optimizing brain protection after cardiac arrest: advanced strategies and best practices.Interface focus · 2024Review
- Plasma glial fibrillary acidic protein and tau: predictors of neurological outcome after cardiac arrest.Critical care (London, England) · 2024Observational
- Serum total tau, neurofilament light, and glial fibrillary acidic protein are associated with mortality in a population study.Journal of the American Geriatrics Society · 2024Article
- Predictive Performance of Neuron-Specific Enolase (NSE) for Survival after Resuscitation from Cardiac Arrest: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Review
- Serum proteome profiles in patients treated with targeted temperature management after out-of-hospital cardiac arrest.Intensive care medicine experimental · 2023Article
- Novel serum biomarkers for predicting neurological outcomes in postcardiac arrest patients treated with targeted temperature management.Critical care (London, England) · 2023Observational
- Brain Injury Biomarkers for Predicting Outcome After Cardiac Arrest.Critical care (London, England) · 2022Review
- Blood GFAP as an emerging biomarker in brain and spinal cord disorders.Nature reviews. Neurology · 2022Review
- GFAp and tau protein as predictors of neurological outcome after out-of-hospital cardiac arrest: A post hoc analysis of the COMACARE trial.Resuscitation · 2022Article
- Brain injury, endothelial injury and inflammatory markers are elevated and express sex-specific alterations after COVID-19.Journal of neuroinflammation · 2021Article
- European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care.Intensive care medicine · 2021Article
- Neurofilament to predict post-anoxic neurological outcome: are we ready for the prime time?Intensive care medicine · 2021Article
- Adult Advanced Life Support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations.Resuscitation · 2020Article
- Macrophage-specific protein perforin-2 is associated with poor neurological recovery and reduced survival after sudden cardiac arrest.Resuscitation · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe neurological prognosis of patients after cardiopulmonary resuscitation (CPR) is difficult to assess. GFAP is an astrocytic intermediate filament protein released into bloodstream in case of cell death. We performed a prospective study aiming to compare the predictive potential of GFAP after resuscitation to the more widely used biomarker neuron-specific enolase (NSE).
methodsOne hundred patients were included at 48 h (tolerance interval ±12 h) after cardiac arrest. A serum sample was collected immediately after study inclusion. We determined serum levels of GFAP and NSE by means of immunoassays. Primary outcome was the modified Glasgow outcome scale at 4 weeks. Values below four were considered as a poor functional outcome.
resultsMedian GFAP levels in poor outcome (n = 61) and good outcome (n = 39) patients were 0.03 μg/L (interquartile range 0.01-0.07 μg/L) and 0.02 μg/L (0.01-0.03 μg/L; p = 0.014), respectively. GFAP revealed a sensitivity of 60.7% and a specificity of 66.7% to predict a poor functional outcome. All patients having a GFAP level >0.08 µg/L had a poor functional outcome. For NSE, sensitivity was 44.3% and specificity was 100.0% for predicting a poor outcome. Multivariate regression analysis revealed GFAP, NSE, and the Karnofsky index to be independent predictors of outcome.
conclusionsThe release patterns of GFAP and NSE after CPR show differences. GFAP levels above 0.08 µg/L were associated with a poor outcome in all cases, and patients with strongly elevated values (>3 µg/L) consistently had severe brain damage on brain imaging. Both biomarkers independently contribute to outcome prediction after CPR.
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