20.500.12556/DiRROS-30058 Markers of mitochondrial injury and neurological outcomes of comatose patients after cardiac arrest Elektronski vir Background and Objectives: Most patients who are successfully resuscitated from cardiac arrest remain comatose, and only half regain consciousness 72 h after the arrest. Neuroprognostication methods can be complex and even inconclusive. As mitochondrial components have been identified as markers of post-cardiac-arrest injury and associated with survival, we aimed to investigate cytochrome c and mtDNA in comatose patients after cardiac arrest to compare neurological outcomes and to evaluate the markers' neuroprognostic value. Materials and Methods: This prospective observational study included 86 comatose post-cardiac-arrest patients and 10 healthy controls. Cytochrome c and mtDNA were determined at admission. Neuron-specific enolase (NSE) was measured after 72 h. Additional neuroprognostication methods were performed when patients remained unconscious. Cerebral performance category (CPC) was determined. Results: Cytochrome c was elevated in patients compared to healthy controls (2.029 [0.85-4.97] ng/mL vs. 0 [0.0-0.16], p < 0.001) but not mtDNA (95,228 [52,566-194,060] vs. 41,466 [28,199-104,708] copies/μL, p = 0.074). Compared to patients with CPC 1-2, patients with CPC 3-5 had higher cytochrome c (1.735 [0.717-3.40] vs. 4.109 [1.149-8.457] ng/mL, p = 0.011), with no differences in mtDNA (87,855 [47,598-172,464] vs. 126,452 [69,447-260,334] copies/μL, p = 0.208). Patients with CPC 1-2 and CPC 3-5 differed in all neuroprognostication methods. In patients with good vs. poor neurological outcome, ROC AUC was 0.664 (p = 0.011) for cytochrome c, 0.582 (p = 0.208) for mtDNA, and 0.860 (p < 0.001) for NSE. The correlation between NSE and cytochrome c was moderate, with a coefficient of 0.576 (p < 0.001). Conclusions: Cytochrome c was higher in comatose patients after cardiac arrest compared to healthy controls and higher in post-cardiac-arrest patients with poor neurological outcomes. Although cytochrome c correlated with NSE, its neuroprognostic value was poor. We found no differences in mtDNA. cardiac arrest cytochrome c mitochondria mtDNA neuroprognostication srčni zastoj citokrom c mitohondrije mtDNA nevroprognostika true false true Angleški jezik Slovenski jezik Neznano 2026-06-12 12:55:25 2026-06-12 12:55:26 2026-06-13 03:52:15 0000-00-00 00:00:00 2024 0 0 Nasl. z nasl. zaslona; Opis vira z dne 13. 9. 2024; str. 1-13 iss. 8, [article no.] 1286 Vol. 60 Avg. 2024 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.1 1648-9144 10.3390/medicina60081286 207431427 RAZ_Zivanovic_Ina_2024.pdf RAZ_Zivanovic_Ina_2024.pdf 1 13232C352BA548A35689E8F7DE4038DD 3ecc62d94961016dffb222be6f4847674fe7979b8fa72be4d4fdc52e442caf77 74117d21-664d-11f1-aebd-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=45339 https://www.mdpi.com/1648-9144/60/8/1286 1 435fb7dc-664d-11f1-aebd-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=45338 Univerzitetni klinični center Ljubljana 0 0 0