Circulating IncRNAs and Their Association With Ischemic Stroke Severity and Prognosis: A Systematic Review and Meta‐Analysis

ABSTRACT Background and Aims Stroke is the most significant contributor to morbidity worldwide. Prognostication in stroke patients could lead to better planning and care and, subsequently, better outcomes. Recently, lncRNAs have become a hot topic as biomarkers of different diseases. This study aims to systematically assess the utility of lncRNAs in stroke prognosis. Methods We systematically searched for relevant articles in Medline (via PubMed interface), EMBASE, Web of Science, and Scopus databases from their inception to April 6th, 2024. Inclusions were limited to original peer‐reviewed papers in English that assessed the correlation between circulating lncRNA levels and stroke severity (all subtypes) and/or prognosis. Completeness of the report was evaluated with the “Strengthening the Reporting of Observational Studies in Epidemiology” (STROBE) checklist, and quality assessment was performed with “Quality in Prognosis Studies” (QUIPS) and “Newcastle Ottawa scale” (NOS) checklists. Results Of the 1134 unique citations gathered, 60 were assessed in full text for inclusion, and 30 were included in the final analysis. Although our search strategy covered all stroke subtypes, no eligible studies were found for hemorrhagic stroke; thus, only ischemic stroke and TIA populations were included. We included 30 studies in our analysis, which included 3719 patients and 4433 data points. The pooled correlation between circulating lncRNAs and NIHSS was 0.52 (CI95%:0.43–0.60), and circulating lncRNAs and the modified Rankin Scale was 0.49 (CI95%:0.26–0.67). The pooled odds ratio for the mortality prediction was 1.55 (CI 95%:1.26–1.92). Quality assessment of included studies showed that most of the studies had a low risk of bias and high completeness of report. Conclusion LncRNAs show modest to moderate predictive accuracy in assessing stroke severity and prognosis. While these findings are encouraging, Further research is needed to solidify their utility in stroke care.