Aberrant MiR-126/SPRED1/VEGF In Transient Ischemic Attack And Their Predictive Value For Secondary Cerebral Infarction

Objective:Transient ischemic attack(TIA)is a severe acute stroke warning event that requires urgent intervention.Therefore,early accurate risk assessment and effective treatment are of great significance in improving disease outcomes and prognosis of patients.This study was conducted to observe the changes of miR-126 and its target spouty related EVH,domain containing proteinl(SPRED1)in transient ischemic attack(TIA)and their predictive value for secondary cerebral infarction.Meanwhile,predictive value of these two indexes were compared with the test results of current commonly used predictive methods such as ABCD2 score and diffusion-weighted imaging(DWI).Methods:Baseline characteristics were collected retrospectively from 106 consecutive patients with TIA.Expressions of miR-126,SPRED1 and VEGF in peripheral blood in 3h,6h and 12h after TIA onset were inspected respectively.Predictive effects of miR-126 and SPRED1 on the second cerebral infarction in 30d were analyzed and compared with ABCD2 score and DWI.Results:miR-126 was found declined in 3h((9.48±1.06)after TIA onset,especially at 6h(8.63±1.62)and 12h(6.49±2.78),compared with healthy control(9.35±1.76,t=7.76,P?0.000).SPRED1 was found increased after TIA onset in 3h(58.05±17.53 ng/ml),the 6h(68.06±13.67ng/ml)and 12h(82.64±18.60 ng/ml)point was found significantly elevated compared with healthy control(52.38±13.24 ng/ml,t=1237?P?0.000).A closely negative correlation was found between miR-126 and SPRED1 at 12h point but not 3h and 6h(r=-0.278,P=0.004).Both of miR-126 and SPRED1 at 12h were implied to be sensitive and specific for the diagnosis of TIA.Additionally,significant increases of VEGF were found in 3h(345.61±76.76 ng/ml),6h(461.65±103.87 ng/ml)and 12h(519.22±103.55 ng/ml)of TIA onset relative to healthy control(107.77±26.04)ng/ml,t=26.57,9.76,34.70,P=0.000,0.000,0.000).Through comparing the ROC curve,the area under curve(AUC = 0.716)of the ABCD2 score for the evaluation of secondary cerebral infarction by TIA,is sup erior to the single miR-126(AUC = 0.627)and SPRED1(AUC = 0.629),however the dif ference was not statistically significant(Z = 1.932,1.932,P = 0.053,0.072);It was also tho ught to be superior than evaluating TIA secondary cerebral infarction using a positive DWI result(AUC=0.671),however it's not proven statistically(Z=1.739,P=0.173).Combination of miR-126,SPRED1 and ABCD2 score significantly improved the predictive(Z=2.105,P=0.035).Conclusion:Aberrant miR-126 and SPRED1 induced by TIA onset can be used as potential biomarkers for the estimation of prognosis.