Abstract <p>Obstructive sleep apnea syndrome (OSAS) is a prevalent comorbidity in patients with acute cerebral infarction (ACI). This study aims to investigate the expression levels of miR-574-5p in patients with ACI concomitant with OSAS, and to explore its potential as a predictive biomarker for clinical diagnosis. The study group included 118 ACI patients. All patients underwent polysomnography (PSG) within 7 days after admission to determine whether they had OSAS. Meanwhile, 50 healthy individuals were selected as the control group. Real-time quantitative PCR was used to detect the expression level of miR-574-5p. Receiver operating characteristic curve was used to determine the diagnostic value of miR-574-5p. Pearson correlation analysis was used to analyze the correlation between serum miR-574-5p expression and disease progression and clinical routine indicators. Logistic regression was used to analyze the risk factors of ACI with OSAS. The expression of miR-574-5p is significantly up-regulated in ACI patients with OSAS, which has a high diagnostic value for ACI patients with OSAS. The level of miR-574-5p increased with the severity of the disease, and was positively correlated with NHISS, mRS scores and AHI values. Moreover, miR-574-5p is a risk factor for ACI with OSAS. For the diagnosis of ACI with OSAS, miR-574-5p is expected to be a predictive biomarker.</p>