2068 miR34c, a Prognostic Biomarker for Delayed Cerebral Ischemia

INTRODUCTION: Delayed cerebral ischemia (DCI) is a devastating complication from aneurysmal subarachnoid hemorrhage (aSAH) without a universally-accepted prediction model. miR34c belongs to a micro-RNA family that has shown to play pivotal roles in neurologic diseases, including neuroinflammatory disorders, drug-resistant epilepsy, and reperfusion injury from ischemic stroke, but its association with DCI has not been studied. METHODS: This prospective study is based on aSAH patients admitted to the neuroscience intensive care unit at the Memorial Herman Hospital-Texas Medical Center, Houston. Serum samples were obtained within 48 hours after the index event, and log-transformed, normalized miR34c expression levels were measured and calculated. Adjusted odds ratios were calculated based on a multivariate logistic regression model, and associations between the expression level and clinical factors were analyzed based on multivariate linear regression models. RESULTS: Among 97 aSAH patients, 25 (25.8%) suffered DCI. 75% of the patients were female, and the median age was 54 (IQR: 46-63). On average, there was 10.1-fold increase in the miR34c level in patients with DCI against without DCI. After adjusting for age, sex, histories of diabetes mellitus and hypertension, and the dichotomized Hunt-Hess grades, a two-fold increase in miR34c showed 1.31 (p-value=0.014, 95% CI 1.09-1.69)-fold increased odds of DCI. Among clinical factors, not receiving any interventions, as compared to coil-embolization or surgical clipping, showed a significant association with the elevated miR34c level (p-value<0.05). CONCLUSIONS: In aSAH patients, elevated miR34c expression is associated with increased odds of having DCI, without other investigated clinical factors showing associations with the miR34c level. Further studies are needed to pathophysiological mechanism behind the found association.