Proteomic analysis, targeted temperature management
Proteomic analysis, targeted temperature management: Biobank serum samples from patients that were included in the TTM trial will be used for proteomic analysis. TTM trial randomised patients to targeted temperature management of 33 °C or 36 °C.
Study summary
Cardiac arrest remains a large contributor to morbidity and mortality. Animal studies suggest an improvement in mortality and neurological function with hypothermia after cardiac arrest, a finding that could not be verified in large clinical trials such as Target Temperature Management after Out-of-hospital Cardiac arrest (TTM) trial. Multimodal neuroprognostication is an important tool for differentiating patients that will recover after cardiac arrest, and currently only one biomarker is in clinical use. The purpose of this study is to explore proteomics profiles in TTM trial patients in order to search for potential novel biomarkers, therapeutic targets, and to explore phenotypes of post-cardiac arrest syndrome.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria as defined in the TTM trial (NCT01020916):
* Age ≥ 18 years old
* Out-of-hospital cardiac arrest (OHCA) of presumed cardiac cause
* Return of spontaneous circulation (ROSC)
* Unconsciousness (Glasgow Coma Score \< 8) (patients not able to obey verbal commands) after sustained ROSC
Exclusion Criteria as defined in the TTM trial (NCT01020916):
* In-hospital cardiac arrest
* OHCA of presumed non-cardiac cause, e.g. after trauma or dissection/rupture of major artery OR Cardiac arrest caused by initial hypoxia (i.e. drowning, suffocation, hanging).
* Known bleeding diathesis (medically induced coagulopathy (e.g warfarin, clopidogrel) does not exclude the patient).
* Suspected or confirmed acute intracranial bleeding
* Suspected or confirmed acute stroke
* Unwitnessed asystole
* Known limitations in therapy and Do Not Resuscitate-order
* Known disease making 180 days survival unlikely
* Known pre-arrest CPC 3 or 4
* Temperature \< 30°C on admission
* \> 4 hours (240 minutes) from ROSC to screening
* Systolic blood pressure \< 80 mm Hg in spite of fluid loading/vasopressor and/or inotropic medication/intra aortic balloon pump. If the systolic blood pressure (SBP) is recovering during the inclusion window (220 minutes) the patient can be included.
Primary outcome measure(s)
Differential protein abundance — Differential protein abundance is evaluated 24, 48, and/or 72 hours after return of spontaneous circulation after cardiac arrest. Clinical outcomes are evaluated 180 days after cardiac arrest. Differential protein abundance will be acquired using proteomic analysis of serum samples. Protein abundance will be stratified in statistical analysis according to pre-specified clinical outcomes.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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