J Stroke.
2017 Sep;19(3):323-332. 10.5853/jos.2017.00423.
MicroRNA 150-5p Improves Risk Classification for Mortality within 90 Days after Acute Ischemic Stroke
- Affiliations
-
- 1Department of Neurology, University Hospital of Zurich, Zurich, Switzerland. mira.katan@usz.ch
- 2Competence Center in Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg.
- 3Medical University Clinic, Cantonal Hospital Aarau, Aarau, Switzerland.
- 4Department of Neurology, University Hospital of Würzburg, Würzburg, Germany.
- 5Department of Endocrinology, University Hospital of Basel, Basel, Switzerland.
- 6Cardiovascular Research Unit, Luxembourg Institute of Health, Strassen, Luxembourg.
- KMID: 2408398
- DOI: http://doi.org/10.5853/jos.2017.00423
Abstract
- BACKGROUND AND PURPOSE
Micro ribonucleic acid-150-5p (miR-150-5p) regulates proinflammatory cytokines as well as vessel integrity. We evaluated the incremental prognostic value of logarithm (log) of miR-150-5p plasma levels after ischemic stroke.
METHODS
In a prospective cohort study, levels of miR-150-5p were measured within 72 hours of symptom onset in 329 ischemic stroke patients. The outcome measures were unfavorable functional outcome (assessed by the modified Rankin Scale score >2) and mortality within 90 days. Logistic regression and Cox proportional hazards models were fitted to estimate odds ratio (OR), respectively hazard ratio (HR) and 95% confidence interval (CI) for the association between log-miR-150-5p and the outcome measures. The discriminatory accuracy was assessed with the area under the receiver-operating-characteristic curve (AUC) and the incremental prognostic value was estimated with the net reclassification index.
RESULTS
After adjusting for demographic and vascular risk factors, lower log-miR-150-5p levels were independently associated with mortality (HR 0.21 [95% CI, 0.08-0.51], P=0.001) but not functional outcome (OR 1.10 [95% CI, 0.54-2.25], P=0.79). Adding log-miR-150-5p improved the discriminatory accuracy of the best multivariate model to predict mortality from an AUC of 0.91 (95% CI, 0.88-0.95) to 0.92 (95% CI, 0.88-0.96 Likelihood-ratio test-P < 0.001), and resulted in a net reclassification index of 37.3% (95% CI, 0.28-0.52).
CONCLUSIONS
In patients with ischemic stroke, log-miR-150-5p is a novel prognostic biomarker, highly associated with mortality within 90 days, improving risk classification beyond traditional risk factors.
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