{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:19:44Z","timestamp":1788185984220,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early neuroprognostication in Out\u2010of\u2010Hospital Cardiac Arrest (OHCA) remains challenging due to the lack of reliable biomarkers. Circulating microRNAs have emerged as potential indicators of inflammation and brain injury (HIBI). This study aimed to evaluate whether in silico\u2010predicted microRNAs could discriminate neurological outcomes early in OHCA patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive OHCA patients admitted to the Acute Cardiac Care Unit with available cryopreserved blood samples were analysed. Neurological outcome was classified into favourable (Cerebral Performance Category (CPC) 1\u20132) and unfavourable (CPC 3\u20135). Blood samples at 0, 24, 72\u2009h after hospital admission were collected. An in silico\u2010derived network of inflammation\u2010HIBI\u2010related microRNA was generated and validated in all patients at the three time\u2010points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 100 patients were included (59.7\u2009\u00b1\u200912.5\u2009years, 19% women). 53% had unfavourable neurological outcomes. Eleven candidate microRNAs were identified, showing differential time\u2010dependent expression within 72\u2009h. The earlier and most predictive microRNAs for unfavourable neurological outcome were miR\u20101\u20103p (AUC 0.637) and miR\u2010124\u20103p (AUC 0.606) at 0\u2009h, miR\u201021\u20105p (AUC 0.614) and miR\u2010499a\u20105p (AUC 0.645) at 24\u2009h. The miR\u2010499\u20105p maintained the best AUC across all time\u2010points. A multiparametric model achieved an AUC of 0.690. A pro\u2010inflammatory environment, characterised by C\u2010Reactive Protein (CRP) and neutrophil\u2010to\u2010lymphocyte ratio, showed distinct temporal expression patterns regarding neurological outcome. Neuroinflammatory miR\u2010let\u20107a\u20105p, miR\u201023a\u20103p and miR\u2010146a\u20105p were significantly overexpressed in the unfavourable group and correlated positively with CRP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In silico derived inflammatory and HIBI\u2010related microRNAs showed time\u2010dependent expression patterns that may distinguish neurological outcomes within 72\u2009h after OHCA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eci.70251","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:34:53Z","timestamp":1787290493000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["MicroRNA and Inflammatory Biomarker Signatures Associated With Neurological Outcome After Out\u2010Of\u2010Hospital Cardiac Arrest: The MiRacle Study"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5139-9774","authenticated-orcid":false,"given":"Francisco Rafael","family":"Jim\u00e9nez\u2010Trinidad","sequence":"first","affiliation":[{"name":"Fundaci\u00f3 Clinic Per la Recerca Biom\u00e8dica Institute d'Investigacions Biom\u00e8diques August Pi i Sunyer (FCRB\u2010IDIBAPS)  Barcelona Spain"},{"name":"Department of Cardiovascular Sciences Fondazione Policlinico Universitario Agostino Gemelli \u2013 IRCCS  Roma Italy"},{"name":"Department of Pharmacology, Therapeutics, and Toxicology Universitat Autonoma de Barcelona (UAB)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7476-874X","authenticated-orcid":false,"given":"Eva","family":"Moreno\u2010Monterde","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3 Clinic Per la Recerca Biom\u00e8dica Institute d'Investigacions Biom\u00e8diques August Pi i Sunyer 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