MicroRNA 150-5p Improves Risk Classification for Mortality within 90 Days after Acute Ischemic Stroke.
- Author:
Natalie SCHERRER
1
;
Francois FAYS
;
Beat MUELLER
;
Andreas LUFT
;
Felix FLURI
;
Mirjam CHRIST-CRAIN
;
Yvan DEVAUX
;
Mira KATAN
Author Information
- Publication Type:Original Article
- Keywords: MicroRNAs; Prognosis; Stroke; Biomarkers; Mortality; Ischemic stroke
- MeSH: Area Under Curve; Biomarkers; Classification*; Cohort Studies; Cytokines; Humans; Logistic Models; MicroRNAs*; Mortality*; Odds Ratio; Outcome Assessment (Health Care); Plasma; Prognosis; Proportional Hazards Models; Prospective Studies; Risk Factors; Stroke*
- From:Journal of Stroke 2017;19(3):323-332
- CountryRepublic of Korea
- Language:English
- 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.
