Department of Laboratory Services, Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Bandar Seri Begawan, Brunei Darussalam.
Department of Clinical Biochemistry, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
Adv Clin Chem. 2019;91:99-122. doi: 10.1016/bs.acc.2019.03.003. Epub 2019 Apr 24.
Acute myocardial infarction (AMI) and heart failure (HF) are two major causes of cardiovascular mortality and morbidity. Early diagnosis of these conditions is essential to instigate immediate treatment that may result in improved outcomes. Traditional biomarkers of AMI include cardiac troponins and other proteins released from the injured myocardium but there are a number of limitations with these biomarkers especially with regard to specificity. In the past few years circulating nucleic acids, notably microRNA that are small non-coding RNAs that regulate various cellular processes, have been investigated as biomarkers of disease offering improved sensitivity and specificity in the diagnosis and prognostication of various conditions. In this review, the role of microRNAs as biomarkers used in the diagnosis of AMI and HF is discussed, their advantage over traditional biomarkers is outlined and the potential for their implementation in clinical practice is critically assessed.
急性心肌梗死(AMI)和心力衰竭(HF)是心血管死亡率和发病率的两个主要原因。早期诊断这些病症对于启动可能导致改善结果的即时治疗至关重要。AMI 的传统生物标志物包括心肌损伤时释放的肌钙蛋白和其他蛋白,但这些生物标志物存在许多局限性,特别是在特异性方面。在过去几年中,循环核酸,特别是作为调节各种细胞过程的小型非编码 RNA 的 microRNA,已被作为疾病的生物标志物进行研究,在各种病症的诊断和预后方面提供了更高的灵敏度和特异性。在这篇综述中,讨论了 microRNA 作为 AMI 和 HF 诊断中使用的生物标志物的作用,概述了它们优于传统生物标志物的优势,并批判性地评估了它们在临床实践中的应用潜力。