Blood biomarkers after cardiac arrest - prognosis and prediction

Most cardiac arrest (CA) patients admitted to intensive care are unconscious and dependent of advanced therapies. The CA syndrome is heterogenous, which is considered a barrier to establishing novel treatments.

Additionally, there is a lack of prognostic markers to guide continuation or withdrawal of life sustaining therapies.Purpose and aims: To analyze blood biomarkers that accurately can prognosticate long term survival with a good neurological outcome, and with gene and protein expression profiles define biologically plausible sub-phenotypes of the CA syndrome to investigate differentiated treatment effects of interventions, and to guide stratification in randomized trials.Organization and method: 4 biobanks nested in large cardiac arrest trials with serial sampling over the first 3 days after CA.

Outcome available at 6-months after CA.

Single protein and panel-assays, total RNA sequencing, quantPCR and protein mass-spectrometry and bioinformatics.Time plan and implementation: 3 of 4 biobanks are complete with 46000 cryovials available. The fourth and broadest biobank will be available in 2027 and used as a validation cohort during 2027-29.

Preliminary work ongoing.

The first clinically available biomarker expected to be launched in 2025.Relevance: The project may inform clinical practice worldwide since blood biomarkers are objective and cost effective. The CA patient will benefit of safer prognostication and effective therapies will be easier to tailor to patient needs.