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Stefanizzi FM, Zhang L, Salgado-Somoza A, Dankiewicz J, Stammet P, Hassager C, Wise MP, Friberg H, Cronberg T, Hundt A, Kjaergaard J, Nielsen N, Devaux Y. Circular RNAs to predict clinical outcome after cardiac arrest. Intensive Care Med Exp 2022; 10:41. [PMID: 36303007 PMCID: PMC9613847 DOI: 10.1186/s40635-022-00470-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 10/05/2022] [Indexed: 11/12/2022] Open
Abstract
Background Cardiac arrest (CA) represents the third leading cause of death worldwide. Among patients resuscitated and admitted to hospital, death and severe neurological sequelae are frequent but difficult to predict. Blood biomarkers offer clinicians the potential to improve prognostication. Previous studies suggest that circulating non-coding RNAs constitute a reservoir of novel biomarkers. Therefore, this study aims to identify circulating circular RNAs (circRNAs) associated with clinical outcome after CA. Results Whole blood samples obtained 48 h after return of spontaneous circulation in 588 survivors from CA enrolled in the Target Temperature Management trial (TTM) were used in this study. Whole transcriptome RNA sequencing in 2 groups of 23 sex-matched patients identified 28 circRNAs associated with neurological outcome and survival. The circRNA circNFAT5 was selected for further analysis using quantitative PCR. In the TTM-trial (n = 542), circNFAT5 was upregulated in patients with poor outcome as compared to patients with good neurological outcome (p < 0.001). This increase was independent of TTM regimen and sex. The adjusted odds ratio of circNFAT5 to predict neurological outcome was 1.39 [1.07–1.83] (OR [95% confidence interval]). CircNFAT5 predicted 6-month survival with an adjusted hazard ratio of 1.31 [1.13–1.52].
Conclusion We identified circulating circRNAs associated with clinical outcome after CA, among which circNFAT5 may have potential to aid in predicting neurological outcome and survival when used in combination with established biomarkers of CA. Supplementary Information The online version contains supplementary material available at 10.1186/s40635-022-00470-7.
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Affiliation(s)
- Francesca M Stefanizzi
- Cardiovascular Research Unit, Department of Population Health, Luxembourg Institute of Health, 1A-B rue Edison, 1445, Strassen, Luxembourg
| | - Lu Zhang
- Cardiovascular Research Unit, Department of Population Health, Luxembourg Institute of Health, 1A-B rue Edison, 1445, Strassen, Luxembourg
| | - Antonio Salgado-Somoza
- Cardiovascular Research Unit, Department of Population Health, Luxembourg Institute of Health, 1A-B rue Edison, 1445, Strassen, Luxembourg
| | - Josef Dankiewicz
- Department of Cardiology, Clinical Sciences, Lund University and Skane University Hospital, 221 85, Lund, Sweden
| | - Pascal Stammet
- Department of Intensive Care Medicine, Centre Hospitalier de Luxembourg, 1210, Luxembourg, Luxembourg.,Department of Life Sciences and Medicine, Faculty of Science, Technology and Medicine, University of Luxembourg, 4365, Esch-sur-Alzette, Luxembourg
| | - Christian Hassager
- Department of Cardiology B, The Heart Centre, Rigshospitalet University Hospital, 2100, Copenhagen, Denmark
| | - Matthew P Wise
- Department of Intensive Care, University Hospital of Wales, Cardiff, CF14 4XW, UK
| | - Hans Friberg
- Department of Anesthesia and Intensive Care, Clinical Sciences, Lund University and Skane University Hospital, 221 85, Malmö, Sweden
| | - Tobias Cronberg
- Department of Neurology and Rehabilitation Medicine, Clinical Sciences, Lund University and Skane University Hospital, 221 85, Lund, Sweden
| | - Alexander Hundt
- Integrated BioBank of Luxembourg, Luxembourg Institute of Health, Dudelange, Luxembourg
| | - Jesper Kjaergaard
- Department of Cardiology B, The Heart Centre, Rigshospitalet University Hospital, 2100, Copenhagen, Denmark
| | - Niklas Nielsen
- Department of Anesthesia and Intensive Care, Clinical Sciences, Lund University and Helsingborg Hospital, 25187, Lund, Sweden
| | - Yvan Devaux
- Cardiovascular Research Unit, Department of Population Health, Luxembourg Institute of Health, 1A-B rue Edison, 1445, Strassen, Luxembourg.
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