naa a22 4500 510746160 CHVBK 20180411083047.0 cr unu---uuuuu 180411e20130701xx s 000 0 eng 10.1007/s12192-012-0399-2 doi (NATIONALLICENCE)springer-10.1007/s12192-012-0399-2 Persistently elevated extracellular HSP70 (HSPA1A) level as an independent prognostic marker in post-cardiac-arrest patients [Elektronische Daten] [Zsigmond Jenei, Gábor Széplaki, Béla Merkely, István Karádi, Endre Zima, Zoltán Prohászka] 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 24h, and followed up for 30days. 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. Cell Stress Society International, 2013 HSP70 nationallicence HSPA1A nationallicence Cardiac arrest nationallicence Hypoxia-ischemia nationallicence Inflammation nationallicence Mild hypothermia nationallicence Jenei Zsigmond 3rd Department of Internal Medicine, Semmelweis University Budapest, Budapest, Hungary aut Széplaki Gábor Department of Intensive Care of Heart Center, Semmelweis University Budapest, Budapest, Hungary aut Merkely Béla Department of Intensive Care of Heart Center, Semmelweis University Budapest, Budapest, Hungary aut Karádi István 3rd Department of Internal Medicine, Semmelweis University Budapest, Budapest, Hungary aut Zima Endre Department of Intensive Care of Heart Center, Semmelweis University Budapest, Budapest, Hungary aut Prohászka Zoltán 3rd Department of Internal Medicine, Semmelweis University Budapest, Budapest, Hungary aut Cell Stress and Chaperones Springer Netherlands 18/4(2013-07-01), 447-454 1355-8145 18:4<447 2013 18 12192 https://doi.org/10.1007/s12192-012-0399-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12192-012-0399-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Jenei Zsigmond 3rd Department of Internal Medicine, Semmelweis University Budapest, Budapest, Hungary aut NATIONALLICENCE 700 1- Széplaki Gábor Department of Intensive Care of Heart Center, Semmelweis University Budapest, Budapest, Hungary aut NATIONALLICENCE 700 1- Merkely Béla Department of Intensive Care of Heart Center, Semmelweis University Budapest, Budapest, Hungary aut NATIONALLICENCE 700 1- Karádi István 3rd Department of Internal Medicine, Semmelweis University Budapest, Budapest, Hungary aut NATIONALLICENCE 700 1- Zima Endre Department of Intensive Care of Heart Center, Semmelweis University Budapest, Budapest, Hungary aut NATIONALLICENCE 700 1- Prohászka Zoltán 3rd Department of Internal Medicine, Semmelweis University Budapest, Budapest, Hungary aut NATIONALLICENCE 773 0- Cell Stress and Chaperones Springer Netherlands 18/4(2013-07-01), 447-454 1355-8145 18:4<447 2013 18 12192 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer