Serum tau fragments as predictors of death or poor neurological outcome after out-of-hospital cardiac arrest
Johannes Grand, Jesper Kjaergaard, Niklas Nielsen, Hans Friberg, Tobias Cronberg, John Bro-Jeppesen,  show all
Received 22 Feb 2019, Accepted 13 Apr 2019, Accepted author version posted online: 24 Apr 2019, Published online: 31 May 2019
Download citation  https://doi.org/10.1080/1354750X.2019.1609580 

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Abstract
Background: Anoxic brain injury is the primary cause of death after resuscitation from out-of-hospital cardiac arrest (OHCA) and prognostication is challenging. The aim of this study was to evaluate the potential of two fragments of tau as serum biomarkers for neurological outcome.

Methods: Single-center sub-study of 171 patients included in the Target Temperature Management (TTM) Trial randomly assigned to TTM at 33 °C or TTM at 36 °C for 24 h after OHCA. Fragments (tau-A and tau-C) of the neuronal protein tau were measured in serum 24, 48 and 72 h after OHCA. The primary endpoint was neurological outcome.

Results: Median (quartile 1 – quartile 3) tau-A (ng/ml) values were 58 (43–71) versus 51 (43–67), 72 (57–84) versus 71 (59–82) and 76 (61–92) versus 75 (64–89) for good versus unfavourable outcome at 24, 48 and 72 h, respectively (pgroup = 0.95). Median tau C (ng/ml) values were 38 (29–50) versus 36 (29–49), 49 (38–58) versus 48 (33–59) and 48 (39–59) versus 48 (36–62) (pgroup = 0.95). Tau-A and tau-C did not predict neurological outcome (area under the receiver-operating curve at 48 h; tau-A: 0.51 and tau-C: 0.51).

Conclusions: Serum levels of tau fragments were unable to predict neurological outcome after OHCA.

Keywords: Serum biomarkers, tau fragments, neurological outcome, out-of-hospital cardiac arrest, prognosis