Novel blood marker may help predict cognitive impairment after a cardiac arrest
Embargo 21 March – 17:40 CET
Key take-aways
Lisbon, Portugal – 21 March 2026: Routine early measurement of neurofilament light chain could help improve prediction of cognitive impairment after out-of-hospital cardiac arrest, according to a study presented today at ESC Acute CardioVascular Care 2026,[1] the annual congress of the Association for Acute CardioVascular Care (ACVC), a branch of the European Society of Cardiology (ESC).
After an out-of-hospital cardiac arrest, the brain is highly susceptible to injury and a range of tests are used by clinicians to predict if survivors have brain damage. “Currently, we measure neuron-specific enolase in the blood as a marker of brain injury but there are concerns about its reliability as factors other than brain damage can lead to high levels,” explained study presenter, Doctor Martin Meyer from Rigshospitalet – Copenhagen University, Denmark. He continued: “Another blood biomarker, neurofilament light chain, has potentially better diagnostic performance than neuron-specific enolase.[2,3] We compared neurofilament light chain and neuron-specific enolase for the prediction of long-term cognitive function in survivors of out-of-hospital cardiac arrest.”
The study analysed blood samples from participants in the Blood Pressure and Oxygenation Targets after Cardiac Arrest (BOX) trial who had been resuscitated from out-of-hospital cardiac arrest and were comatose on hospital admission. Levels of neurofilament light chain and levels of neuron-specific enolase were measured in samples taken 48 hours after cardiac arrest.
Data on cognitive function, assessed by the Montreal Cognitive Assessment (MoCA) score months after the cardiac arrest, were available for a subset of survivors who had both neurofilament light chain and neuron-specific enolase measurements.
The key finding of the investigation is that neurofilament light chain levels at 48 hours were inversely correlated with MoCA score, i.e. higher blood levels of neurofilament light chain were indicative of worse long-term cognitive function.
In contrast, no association was observed for neuron-specific enolase levels at 48 hours and cognitive function at follow-up.
Summing up the findings, Doctor Meyer concluded: “Neurofilament light chain levels measured early after cardiac arrest, while patients were still admitted to hospital, were related to long-term cognitive function. This association with cognitive function was not observed with neuron-specific enolase testing. The introduction of routine early neurofilament light chain measurement could potentially assist in the identification of patients at high risk, helping to optimise decision-making about other tests and scans, improve the targeting of rehabilitation and enable clinicians to better inform patients and their families about expectations for the future.” Further validation and standardisation of neurofilament light chain assays are now needed.
ENDS
Notes to Editor
Funding: The Novo Nordisk Foundation, Denmark provided an unrestricted research grant for the BOX trial. The measurement of neurofilament light chain was supported by the Heart Center Research Council, Rigshospitalet, Denmark.
Disclosures: Doctor Meyer reports no disclosures related to this study.
References:
1’Neurofilament light chain and neuron-specific enolase for estimating long-term cognitive function after cardiac arrest’ presented during the Research Prize session on 21 March at 16:25 to 17:25 in Room 1.
2Meyer MAS, Beske RP, Mølstrøm S, et al. Neurofilament light chain for prognostication after cardiac arrest-first steps towards validation. Crit Care. 2025;29:348.
3Isse YA, Hassager C, Møller JE, et al. Neuron-specific enolase measured in serum compared to plasma for neuroprognostication in out-of-hospital cardiac arrest. Scand J Clin Lab Invest. 2026;86:28–35.
ESC Press Office
Tel: +33 6 61 40 18 84
Email: press@escardio.org
Follow European Society of Cardiology News on LinkedIn
About the European Society of Cardiology
The ESC brings together healthcare professionals from more than 150 countries, working to advance cardiovascular medicine and help people to live longer, healthier lives.
About the Association for Acute CardioVascular Care (ACVC)
The ESC’s Association for Acute CardioVascular Care (ACVC) is the only multidisciplinary community dedicated to every stage of acute cardiovascular care from cardiac event to patient stabilisation. The ACVC offers a unique platform where specialists can share knowledge, access expert education and collaborate towards one mission: working together to save lives.
About ESC Acute CardioVascular Care 2026
ESC Acute CardioVascular Care 2026 takes place from 20–21 March at Centro de Congressos de Lisboa, Lisbon, Portugal. This year’s theme, ‘The Heart Team in Acute Cardiovascular Care,’ celebrates the power of collaboration – uniting physicians, nurses, allied professionals and specialists who make life-saving decisions together.
Explore the scientific programme.
END
Key take-aways
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Predicting which patients suffer brain injury after an out-of-hospital cardiac arrest is challenging.
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The current standard of measuring neuron-specific enolase during hospital admission was compared with testing of a novel marker, neurofilament light chain, for predicting long-term cognitive impairment.
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Levels of neurofilament light chain but not neuron-specific enolase were associated with long-term cognitive dysfunction.
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A routine blood test for neurofilament light chain early after a cardiac arrest may help improve the identification of patients at high risk of long-term cognitive impairment.
Lisbon, Portugal – 21 March 2026: Routine early measurement of neurofilament light chain could help improve prediction of cognitive impairment after out-of-hospital cardiac arrest, according to a study presented today at ESC Acute CardioVascular Care 2026,[1] the annual congress of the Association for Acute CardioVascular Care (ACVC), a branch of the European Society of Cardiology (ESC).
After an out-of-hospital cardiac arrest, the brain is highly susceptible to injury and a range of tests are used by clinicians to predict if survivors have brain damage. “Currently, we measure neuron-specific enolase in the blood as a marker of brain injury but there are concerns about its reliability as factors other than brain damage can lead to high levels,” explained study presenter, Doctor Martin Meyer from Rigshospitalet – Copenhagen University, Denmark. He continued: “Another blood biomarker, neurofilament light chain, has potentially better diagnostic performance than neuron-specific enolase.[2,3] We compared neurofilament light chain and neuron-specific enolase for the prediction of long-term cognitive function in survivors of out-of-hospital cardiac arrest.”
The study analysed blood samples from participants in the Blood Pressure and Oxygenation Targets after Cardiac Arrest (BOX) trial who had been resuscitated from out-of-hospital cardiac arrest and were comatose on hospital admission. Levels of neurofilament light chain and levels of neuron-specific enolase were measured in samples taken 48 hours after cardiac arrest.
Data on cognitive function, assessed by the Montreal Cognitive Assessment (MoCA) score months after the cardiac arrest, were available for a subset of survivors who had both neurofilament light chain and neuron-specific enolase measurements.
The key finding of the investigation is that neurofilament light chain levels at 48 hours were inversely correlated with MoCA score, i.e. higher blood levels of neurofilament light chain were indicative of worse long-term cognitive function.
In contrast, no association was observed for neuron-specific enolase levels at 48 hours and cognitive function at follow-up.
Summing up the findings, Doctor Meyer concluded: “Neurofilament light chain levels measured early after cardiac arrest, while patients were still admitted to hospital, were related to long-term cognitive function. This association with cognitive function was not observed with neuron-specific enolase testing. The introduction of routine early neurofilament light chain measurement could potentially assist in the identification of patients at high risk, helping to optimise decision-making about other tests and scans, improve the targeting of rehabilitation and enable clinicians to better inform patients and their families about expectations for the future.” Further validation and standardisation of neurofilament light chain assays are now needed.
ENDS
Notes to Editor
Funding: The Novo Nordisk Foundation, Denmark provided an unrestricted research grant for the BOX trial. The measurement of neurofilament light chain was supported by the Heart Center Research Council, Rigshospitalet, Denmark.
Disclosures: Doctor Meyer reports no disclosures related to this study.
References:
1’Neurofilament light chain and neuron-specific enolase for estimating long-term cognitive function after cardiac arrest’ presented during the Research Prize session on 21 March at 16:25 to 17:25 in Room 1.
2Meyer MAS, Beske RP, Mølstrøm S, et al. Neurofilament light chain for prognostication after cardiac arrest-first steps towards validation. Crit Care. 2025;29:348.
3Isse YA, Hassager C, Møller JE, et al. Neuron-specific enolase measured in serum compared to plasma for neuroprognostication in out-of-hospital cardiac arrest. Scand J Clin Lab Invest. 2026;86:28–35.
ESC Press Office
Tel: +33 6 61 40 18 84
Email: press@escardio.org
Follow European Society of Cardiology News on LinkedIn
About the European Society of Cardiology
The ESC brings together healthcare professionals from more than 150 countries, working to advance cardiovascular medicine and help people to live longer, healthier lives.
About the Association for Acute CardioVascular Care (ACVC)
The ESC’s Association for Acute CardioVascular Care (ACVC) is the only multidisciplinary community dedicated to every stage of acute cardiovascular care from cardiac event to patient stabilisation. The ACVC offers a unique platform where specialists can share knowledge, access expert education and collaborate towards one mission: working together to save lives.
About ESC Acute CardioVascular Care 2026
ESC Acute CardioVascular Care 2026 takes place from 20–21 March at Centro de Congressos de Lisboa, Lisbon, Portugal. This year’s theme, ‘The Heart Team in Acute Cardiovascular Care,’ celebrates the power of collaboration – uniting physicians, nurses, allied professionals and specialists who make life-saving decisions together.
Explore the scientific programme.
-
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