Routine early measurements of neurofilament light chain may help improve prediction of cognitive impairment after out-of-hospital cardiac arrest, according to research presented today at ESC Acute Cardiovascular Care 2026, the annual meeting of the Association for Acute Cardiovascular Care (ACVC), a branch of the European Society of Cardiology (ESC).
After an out-of-hospital cardiac arrest, the brain is susceptible to damage, so clinicians use a variety of tests to predict whether survivors have brain damage.
Currently, neuron-specific enolase in the blood is measured as a marker of brain injury, but there are concerns about its reliability as factors other than brain injury may cause elevated levels. Another blood biomarker, neurofilament light chain, may have better diagnostic performance than neuron-specific enolase. We compared neurofilament light chain and neuron-specific enolase to predict long-term cognitive function in survivors of out-of-hospital cardiac arrest. ”
Dr. Martin Meyer, Research Presenter, Rigshospitalet – University of Copenhagen, Denmark
This study analyzed blood samples from participants in the Post-Cardiac Blood Pressure and Oxygenation Target (BOX) study who were resuscitated from out-of-hospital cardiac arrest and were comatose upon admission. Neurofilament light chain levels and neuron-specific enolase levels were measured in samples taken 48 hours after cardiac arrest.
Data on cognitive function, as assessed by the Montreal Cognitive Assessment (MoCA) score, were available for a subset of survivors who had measurements of both neurofilament light chain and neuron-specific enolase several months after cardiac arrest.
A key finding of this study was that neurofilament light chain levels after 48 hours were inversely correlated with MoCA scores, i.e., higher blood levels of neurofilament light chain indicated worse long-term cognitive function.
In contrast, no association was observed between neuron-specific enolase levels after 48 hours and cognitive function at follow-up.
Summarizing the findings, Dr. Meyer concluded that “neurofilament light chain levels measured early after cardiac arrest, while patients were still hospitalized, were associated with long-term cognitive function. This association with cognitive function was not observed with neuron-specific enolase testing.”
Introduction of routine early neurofilament light chain measurements may help identify high-risk patients, optimize decision-making regarding other tests and scans, improve targeting of rehabilitation, and allow clinicians to better inform patients and their families about future expectations. ” Further validation and standardization of the neurofilament light chain assay is currently needed.
sauce:
European Society of Cardiology
