LAUSR

Purpose: The purpose of this study is to investigate the association between a disintegrin‐like and metalloprotease with thrombospondin type 1 motif 13 (ADAMTS13) and neurologic outcome in patients with resuscitation of out‐of‐hospital cardiac arrest (R‐OHCA). Materials and Methods: A prospective observational study of adult patients with R‐OHCA was conducted. Plasma activity of ADAMTS13 and inflammatory markers, an immunologic marker, and a marker of endothelial damage were measured on admission and day 2. Neurologic outcome was evaluated using the Cerebral Performance Categories on day 90. Results: Plasma activity of ADAMTS13 on day 2 was lower in patients with poor neurologic outcome (n = 18) than that in those with good neurologic outcome (n = 16; P = .008). It was also lower in 28‐day nonsurvivors (n = 12) than in survivors (n = 21; P = .019). Soluble thrombomodulin showed a strong correlation with ADAMTS13 (P = .021). Furthermore, ADAMTS13 activity was negatively correlated with the Sequential Organ Failure Assessment score (P < .001), levels of high‐mobility group box 1 (P = .028), and levels of interleukin 6 (P = .047) but positively correlated with the monocyte expression of human leukocyte antigen DR (P = .023). Conclusion: Decreased ADAMTS13 activity was associated with poor neurologic outcome, high mortality, and worsened immune‐inflammatory status in patients with R‐OHCA. These results suggest that ADAMTS13 may have pathophysiologic relevance in postcardiac arrest syndrome.