TRANSCRIPTOMIC HORIZONS: THE EMERGENCE OF RNA-BASED BIOMARKERS FOR PROGNOSTICATION AFTER CARDIAC ARREST

Cardiac arrest (CA) remains a leading cause of mortality and long-term neurological disability worldwide. Accurate early prognostication-particularly prediction of neurological outcomes-represents a critical unmet need in post-resuscitation care. Traditional clinical parameters and protein biomarkers exhibit significant limitations in sensitivity and timing. Recent advances in transcriptomic technologies have enabled comprehensive characterization of RNA molecules as dynamic indicators of the systemic and cerebral responses to global ischemia-reperfusion injury. This review synthesizes current evidence on novel transcriptomic markers following CA, encompassing messenger RNAs, non-coding RNAs,and epitranscriptomic modifications. We evaluate the prognostic utility of specific candidates including SLC2A1, microRNA panels, and emerging long non-coding RNAs. The review further examines analytical approaches, from targeted validation to machine learning-driven multi-omic integration, and discusses challenges in clinical translation. Emerging evidence supports the potential of transcriptomic signatures to enhance prognostic accuracy and provide mechanistic insights into post cardiac arrest pathophysiology, though prospective validation in diverse cohorts remains essential.