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Background <p>The utility of circulating microRNAs as early diagnostic biomarkers in the hyperacute phase of acute ischemic stroke (AIS) remains under investigation.</p> Aims <p>To evaluate the diagnostic accuracy of serum miRNA-124 and miRNA-125b at emergency department (ED) admission and to characterize their dynamic changes following acute reperfusion therapy.</p> Methods <p>This prospective, single-center, case-control study included adult patients with AIS in the hyperacute phase, defined as presentation within 6&#xa0;h of symptom onset, who were treated with reperfusion therapy (intravenous thrombolysis and mechanical thrombectomy), along with age- and sex-matched healthy controls. Serum samples were collected at baseline (pretreatment) and 24&#xa0;h post-reperfusion, and miRNA levels were quantified using quantitative real-time polymerase chain reaction. Diagnostic performance was evaluated using receiver operating characteristic curve analysis.</p> Results <p>In total, 20 patients and 10 controls were included. At baseline, serum miRNA-125b levels were significantly elevated in AIS patients compared to controls (<i>p</i> &lt; 0.001), demonstrating high diagnostic accuracy with an area under the curve of 0.910, 95.0% sensitivity, and 90.0% specificity. In contrast, miRNA-124 exhibited no significant difference (<i>p</i> = 0.266) and lacked discriminative value. At 24&#xa0;h post-reperfusion, miRNA-125b levels exhibited a nonsignificant downward trend (<i>p</i> = 0.108). Neither miRNA correlated with baseline stroke severity (NIHSS) or early neurological status (mRS).</p> Conclusions <p>Serum miRNA-125b showed promising preliminary diagnostic performance for AIS at ED admission. A single 24&#xa0;h post-reperfusion measurement exhibited a nonsignificant decline in miRNA-125b and no association of miRNA with early stroke severity or functional outcome.</p>

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Diagnostic accuracy and post-reperfusion kinetics of serum miRNA-125b in hyperacute ischemic stroke: a prospective emergency department case–control study

  • 期刊论文

  • 发表日期：

    2026年7月3日

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  • Dilek Demir Kaya,
  • Huseyin Ergenc,
  • Adem Az,
  • Ozgur Sogut,
  • Muhammed Furkan Ozden,
  • Yunus Dogan,
  • Tuba Betul Umit

摘要

Background

The utility of circulating microRNAs as early diagnostic biomarkers in the hyperacute phase of acute ischemic stroke (AIS) remains under investigation.

Aims

To evaluate the diagnostic accuracy of serum miRNA-124 and miRNA-125b at emergency department (ED) admission and to characterize their dynamic changes following acute reperfusion therapy.

Methods

This prospective, single-center, case-control study included adult patients with AIS in the hyperacute phase, defined as presentation within 6 h of symptom onset, who were treated with reperfusion therapy (intravenous thrombolysis and mechanical thrombectomy), along with age- and sex-matched healthy controls. Serum samples were collected at baseline (pretreatment) and 24 h post-reperfusion, and miRNA levels were quantified using quantitative real-time polymerase chain reaction. Diagnostic performance was evaluated using receiver operating characteristic curve analysis.

Results

In total, 20 patients and 10 controls were included. At baseline, serum miRNA-125b levels were significantly elevated in AIS patients compared to controls (p < 0.001), demonstrating high diagnostic accuracy with an area under the curve of 0.910, 95.0% sensitivity, and 90.0% specificity. In contrast, miRNA-124 exhibited no significant difference (p = 0.266) and lacked discriminative value. At 24 h post-reperfusion, miRNA-125b levels exhibited a nonsignificant downward trend (p = 0.108). Neither miRNA correlated with baseline stroke severity (NIHSS) or early neurological status (mRS).

Conclusions

Serum miRNA-125b showed promising preliminary diagnostic performance for AIS at ED admission. A single 24 h post-reperfusion measurement exhibited a nonsignificant decline in miRNA-125b and no association of miRNA with early stroke severity or functional outcome.