Stroke is the second leading cause of death worldwide, and remains a major cause of disability among survivors. As genomic technology has progressed, this study evaluated the efficacy of a novel RNA biomarker is an indicator of stroke prognosis.

Subjects were obtained from the INTERSTROKE study, a large international, standardized, case control study of patients from 22 countries. The subjects were 129 patients with blood sampling within five days of symptom onset, and 170 control participants with no history of stroke. From these, total RNA was isolated to identify RNA transcripts associated with stroke.

From the analysis, the most significant gene associated with stroke was found to be MCEMP1, which had a 2.4 fold increased expression in stroke cases, as compared to controls. This gene was tested for associations with known stroke risk factors, with no associations found. MCEMP1 was highest in samples collected within 24 hours of symptom onset, as compared with controls or stroke cases collected after 24 hours. MCEMP1 was increased by 4.5 fold in ICH cases as compared with controls, and by 2.1 in ischemic cases compared with controls. Individuals with disabilities at one month had a more elevated baseline MCEMP1 than did controls or individuals without disabilities. MCEMP1 expression was independently associated with the one month modified Rankin Score and death.

This study found that the gene expression of MCEMP1 was elevated in patients with stroke, and was associated with increased morbidity and mortality at one month.