EXR-KJENS1STROKE-ST (Project)

Description:Background and Purpose: Rapid identification of patients suffering from cerebral ischemia and excluding intracerebral hemorrhage can greatly expand patient access to chemical and mechanical revascularization and assist with patient triage. We sought to identify blood-based extracellular RNAs (ex-RNAs) predictive of major stroke subtypes using clinical samples. Methods: We collected blood on patients presenting with intraparenchymal hemorrhage (IPH), aneurysmal subarachnoid hemorrhage (SAH) and ischemic stroke upon admission and confirmation of diagnosis based on clinical and imaging criteria. These samples were subjected to RNA isolation protocols to obtain ex-RNA constituents. Next, next-generation RNA-sequencing and bioinformatic analyses were performed to identify biomarkers predictive of the various stroke subtypes. Results: Extracellular RNAs definitively distinguish between SAH and stroke (C.V. accuracy: 0.95; C.V. standard deviation: 0.08; C.V. confidence interval: 0.94 to 0.95), IPH and stroke (C.V. accuracy: 0.83; C.V. standard deviation: 0.14; C.V. confidence interval: 0.82 to 0.84), and IPH and SAH (C.V. accuracy: 0.95; C.V. standard deviation: 0.09; C.V. confidence interval: 0.94 to 0.95). Conclusions: Blood-based ex-RNAs are predictive biomarkers capable of distinguishing between major stroke subtypes with high confidence. These biomarkers have the potential to serve as point-of-care tests to rapidly and reliably differentiate between major stroke subtypes in the field and aid with the triage of patients to stroke centers and expand pool of patients eligible for rapid chemical and mechanical revascularization. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifiers: NCT02389634 and NCT02389647.

Creation Time:2018-12-11T00:00:00

Abbreviation:KJENS1STROKE