Clinical and prognostic significance of baseline microRNA 223 in acute ischemic stroke

Background Acute ischemic stroke (AIS) is the second leading cause of disability and death worldwide. Micro-RNA (miRNA)-223 was first identified as a regulator of hematopoietic lineage differentiation. Later, its diverse roles were discovered in a wide spectrum of pathological conditions. The present study aimed to assess the clinical and prognostic significance of miR-223 in patients with acute ischemic stroke (AIS). The study included 93 patients with AIS diagnosed on the basis of clinical and radiological findings. In addition, there were 50 healthy subjects who served as controls. Patients were classified into two categories: Those with favorable functional outcome (modified Rankin Scale (mRS): 0-2) and others with unfavorable functional outcome (mRS: 3-6) at 6 months post-stroke. Results The present prospective longitudinal study included 93 patients with AIS. They included 60 males (64.5%) and 33 females (35.5%) with an age of 64.5 +/- 12.4 years. At the end of 6-month follow up, 44 patients (47.3%) had favorable outcome while the remainder 49 patients (52.7%) had unfavorable outcome. Patients with favorable outcome had significantly lower baseline miR-223 levels [median (IQR): 4.4 (2.0-6.3) versus 8.4 (4.5-14.9), p < 0.001], lower HbA1c levels (5.6 +/- 1.0 versus 6.2 +/- 1.2, p = 0.006) and lower C-reactive protein (CRP) levels [median (IQR): 8.9 (5.1-26.7) versus 15.2 (6.2-39.3) mg/dL, p = 0.02]. Multivariate binary logistic regression analysis recognized high baseline miR-223 [OR (95% CI) 1.13 (1.06-1.24), p = 0.011], infarct size [OR (95% CI) 2.58 (1.66-4.77), p = 0.001] and National Institutes of Health Stroke Scale (NIHSS) [OR (95% CI) 2.11 (1.74-3.09), p = 0.004] as significant predictors of unfavorable outcome in the studied patients. Conclusions Elevated baseline miR-223 levels are associated with high NIHSS and larger infarct size at baseline and can effectively predict patients' outcome at 6-months post-stroke.