MicroRNAs as Potential Prognosticators of Neurological Outcome in Out-Of-Hospital Cardiac Arrest Patients

Abstract

Out-of-hospital cardiac arrest survival rates have increased due to advancement in resuscitative measures, yet approximately 90% of survivors ultimately die or have severe neurologic dysfunction caused by ischemic injury. Currently, there are few early prognostic indicators of which patients have possibility of meaningful recovery. This leads to uncertainty for families and clinicians, as well as aggressive, invasive and expensive treatments despite medical futility. Several biomarkers investigated in traumatic brain injury have shown prognostication potential in ischemic brain injury. miRNAs, small noncoding RNAs responsible for gene regulation, have been studied in cardiovascular diseases, and have shown prognostication potential due to tissue specificity and stability in circulation. This review discusses available evidence on miRNAs prognosticating neurological outcomes after out-of-hospital cardiac arrest.

The first national survey on practices of neurological prognostication after cardiac arrest in China, still a lot to do

“…Novel prognostic biomarkers include neurofilament light chain (NFL), tau protein and microRNAs. [31][32][33] Recently in a large sub-study of the TTM trial, serum NFL was shown to have significantly greater performance than the other biomarkers (ie, NSE, S-100 and tau) and its level at 24 hours after CA was even a robust indicator of long-term poor neurologic outcome. 33 No single test can accurately predict the prognosis of patients following CA.…”