Biomarkers in Cardiac Arrest: A Narrative Review

Inflammatory, neurologic, and cardiac biomarkers appear to have varying significance in the prognostication of patients with cardiac arrest. Post-cardiac arrest syndrome is a condition characterized by systemic ischemia with reperfusion injury, neurologic damage, and myocardial dysfunction. The relative significance of these biomarkers remains unclear and is an area of active investigation. In this narrative review, we aim to describe what is currently known about the role of inflammatory, neurologic, and cardiac biomarkers in cardiac arrest. A PubMed review was performed for relevant articles. Articles that studied inflammatory, neurologic, and cardiac biomarkers in adult cardiac arrest were included. This narrative review determined that biomarkers play a key role in facilitating prognostication of patients with cardiac arrest. The release of inflammatory, neurologic, and cardiac biomarkers mediates inflammation, ischemic brain injury, and myocardial dysfunction. Inflammatory and neurologic biomarkers appear to have more clinical utility than cardiac biomarkers. When combined with physical exam, imaging and electroencephalograph findings, blood biomarkers can be useful in making predictions of patient outcomes post-cardiac arrest. Despite this utility, no single biomarker has sufficient power to predict patient outcomes independently. Ongoing research investigating these biomarkers remains an area of strong clinical interest. In conclusion, inflammatory, neurologic, and cardiac biomarkers all play a role in understanding both the short-term and long-term outcomes in patients with cardiac arrest. To date, no single parameter has been shown to reliably predict outcome in cardiac arrest patients. Such biomarkers remain an area of active investigation.