Sudden cardiac death (SCD) is a major cause of mortality in industrialized countries and
represents a major health issue. The survival rate after out-of-hospital cardiac arrest
(OHCA) is only 10-15%, regardless of first recorded rhythm. Prior heart disease is a major
risk factor for sudden cardiac arrest (SCA), and coronary artery disease (CAD) is the most
common underlying cause. A better understanding of pathophysiological mechanisms occurring
during cardiac arrest (CA), earlier diagnosis of underlying cause as well as identification
of risk factors related to CA may improve patient treatment and increase survival. In our
out-of-hospital cardiac arrest (OHCA)-study, we intend to investigate whether biomarkers,
such as copeptin, hs-cTnT and NT-proBNP in addition to clinical evaluation may improve risk
stratification and supply information related to pathophysiology.
Furthermore, we intend to gather additional pathophysiological information related to
coagulation activation in CA and cardiopulmonary resuscitation (CPR), as intravascular
thrombosis may impair microcirculation and reduce end-organ blood flow which is associated
with a poor prognosis. We intend to study coagulation activation during and immediately after
SCA with regard to outcome, and assess the contribution of the intrinsic system, measured
together with that of the extrinsic system.
Low levels of n-3 fatty acids (FA) are reported as a risk factor for SCD. Red blood cell
eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA) may serve as a useful surrogate of
cardiac omega-3 fatty acid status. The exact mechanism by which FAs might protect against
serious cardiac arrhythmias is not known, but they are expected to exert a membrane
stabilizing effect during an ischemic episode. In our study we intend to evaluate the
association between ventricular fibrillation (VF) and the content of EPA and DHA in red blood
cells. Furthermore, as vitamin D is associated with n-3 FAs in the diet, we also aim at
investigating the association between 25-hydroxy (OH)-vitamin D and VF.