الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Several studies showed a significant role of specific circulating miRNA markers in the diagnosis, severity, and prognosis of acute ischemic stroke. So, the identification of plasma levels of some miRNAs such as miR-125b-5p in patients with acute ischemic stroke may provide a better understanding of the reported variability in the outcome after thrombolytic therapy. These miRNAs can be also used as innovative targets in the treatment of acute ischemic stroke. The aim of this work was to comprehensively investigate the role of micro-RNA 125b-5p as a biomarker for stoke severity and as a predictor of functional outcome after thrombolytic therapy The study was conducted on 40 patients with acute ischemic stroke eligible for receiving rt-PA and 40 age and sex matched healthy controls. Patients underwent neurological assessment using NIHSS after admission in stroke unit. It was done immediately before initiating thrombolytic therapy, at day1, and at day 7 after stoke onset. Functional outcome after 3 months was determined using the modified Rankin Scale (mRS). Favorable and unfavorable outcomes were defined as mRS scores of 0–1and 2–6, respectively.CT brain was done for all included patients on admission to insure the absence of hemorrhage or any structural lesion other than infarction. It was repeated 24 hours and 7 days after stroke onset to detect the site and size of infarcted area. Size of the infarction was measured by the pure ellipsoid model of ABC/2Echocardiography was done for all included patients to assess the presence of valvular disease, ejection fraction, left atrium dilatation and cardiomyopathy. Carotid and vertebrobasilar duplex were done to detect atherosclerosis or stenosis of carotid and vertebrobasilar arteries Routine labs were done to all included patients on admission. They included random blood sugar, complete blood count (CBC), international normalized ratio (INR), lipid profile and uric acid.
The plasma micro-RNA 125b-5p levels were measured for both patients and controls by quantitative real time PCR
The results of our study were summarized in the following:• There was a statistically significant difference between rt-PA treated patients and controls in circulating micro-RNA 125b-5plevel (P-value=0.01)• There was no significant effect of either age, BMI, DM, HTN, smoking, drug abuse, family history of stroke, valvular heart diseases, cardiomyopathy, impaired ejection fraction, dilated left atrium, diastolic dysfunction or pulmonary hypertension, or carotid artery disease, on circulating micro-RNA 125b-5plevel. •Patients with a past history of stroke had significantly higher circulating micro-RNA 125b-5plevel than those with first ever stroke (P-value ≤0.001)• There was no statistically significant difference between patients with large artery stroke, those with cardio-embolic stroke, and those with small artery stroke regarding micro-RNA 125b-5p levels (P-value= 0.61)• Patients with rt-PA complication had significantly higher circulating micro-RNA 125b-5plevel than those without (P-value ≤0.001)• Patients with poor outcome after thrombolysis had significantly higher circulating micro-RNA 125b-5plevel than those without (P-value ≤0.001)• There was no statistically significant correlation between micro-RNA 125b-5p level and either cholesterol, LDL, HDL, RBS, TG, platelets, HCT, WBCs or uric acid•There was a statistically significant positive correlation between micro-RNA 125b-5p level and NIHSS before thrombolysis and at day 7.• There was a statistically significant positive correlation between micro-RNA 125b-5p level and infarction size at day 7 •There was a statistically significant positive correlation between micro-RNA125b-5p level and mRS after 3 months •Logistic regression model revealed that each unit increase in micro-RNA125b-5p decreased the odds of good outcome by 0.095 (CI= 0.016 - 0.58, P-value= 0.011)•Logistic regression model revealed that micro-RNA125b-5p level was not a predictor of .complications from thrombolytic therapy (OR= 4.255, P-value= 0.06)