Department of Cardiology, Faculty of Medicine, Lund University, Skåne University Hospital, SE-221 00, Box 117, Lund, Sweden.
BMC Cardiovasc Disord. 2013 Feb 28;13:12. doi: 10.1186/1471-2261-13-12.
Increased levels of cardio-enriched microRNAs (miRNAs) have been described in patients with myocardial infarction (MI). We wanted to evaluate the diagnostic and prognostic potential of cardio-enriched miRNAs in patients presenting with a suspected acute coronary syndrome (ACS).
Cardio-enriched miRNAs (miR-1, miR-208b and miR-499-5p) were measured using real time PCR in plasma samples from 424 patients with suspected ACS treated in a coronary care unit. miRNAs were assessed for discrimination of a clinical diagnosis of myocardial infarction and for association with 30-day mortality and diagnosis of heart failure. Correlation with left ventricular systolic dysfunction as measured by the ejection fraction (LVEF) was also assessed. To confirm myocardial origin miRNA was measured during coronary artery bypass surgery.
miRNAs were higher in MI patients and correlated with LVEF (p < 0.001). Discrimination of MI was accurate for miR-208b (AUC = 0.82) and miR-499-5p (AUC = 0.79) but considerable lower than for Troponin T (AUC = 0.95). Increased miRNA levels were strongly associated with increased risk of mortality or heart failure within 30 days for miR-208b (OR 1.79, 95% CI = 1.38-2.23, p = 1 × 10(-5)) and miR-499-5p (OR 1.70, 95% CI = 1.31-2.20, p = 5 × 10(-5)) but the association was lost when adjusting for Troponin T. During surgery miR-208b and miR-499-5p was released in the coronary sinus after cardioplegia-reperfusion to markedly higher levels than in a peripheral vein.
Our findings confirm increased levels of cardio-enriched miRNAs in the blood of MI patients and establish association of increased miRNA levels with reduced systolic function after MI and risk of death or heart failure.
心肌梗死（MI）患者的心脏富含 microRNAs（miRNAs）水平升高。我们希望评估在疑似急性冠脉综合征（ACS）患者中富含心脏的 miRNAs 的诊断和预后潜力。
在冠状动脉护理病房中治疗的 424 例疑似 ACS 患者的血浆样本中，使用实时 PCR 测量心脏富含 miRNAs（miR-1、miR-208b 和 miR-499-5p）。评估这些 miRNAs 用于区分心肌梗死的临床诊断，以及与 30 天死亡率和心力衰竭诊断的相关性。还评估了与左心室射血分数（LVEF）测量的左心室收缩功能障碍的相关性。为了确认 miRNA 的心肌来源，在冠状动脉旁路手术后进行了测量。
MI 患者的 miRNA 水平较高，与 LVEF 相关（p<0.001）。miR-208b（AUC=0.82）和 miR-499-5p（AUC=0.79）对 MI 的区分准确性较高，但明显低于 Troponin T（AUC=0.95）。miR-208b（OR 1.79，95%CI=1.38-2.23，p=1×10(-5)) 和 miR-499-5p（OR 1.70，95%CI=1.31-2.20，p=5×10(-5)) 水平升高与 30 天内死亡率或心力衰竭的风险增加密切相关，但在调整 Troponin T 后，这种相关性消失。在手术中，miR-208b 和 miR-499-5p 在心脏停搏后再灌注到冠状窦中释放，水平明显高于外周静脉。
我们的发现证实 MI 患者血液中富含心脏的 miRNAs 水平升高，并确定了 miRNA 水平升高与 MI 后收缩功能降低以及死亡或心力衰竭的风险相关。
