Department of Cardiovascular Medicine, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium.
Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
J Cardiovasc Transl Res. 2021 Apr;14(2):213-221. doi: 10.1007/s12265-020-10048-x. Epub 2020 Jun 30.
The treatment and early outcome of patients with acute myocardial infarction (MI) have dramatically improved the past decades, but the incidence of left ventricular (LV) dysfunction post-MI remains high. Peripheral blood RNAs reflect pathophysiological changes during acute MI and the inflammatory process. Therefore, these RNAs are promising new markers to molecularly phenotype patients and improve the early identification of patients at risk of subsequent LV dysfunction. We here discuss the coding and long non-coding RNAs that can be measured in peripheral blood of patients with acute MI and list the advantages and limitations for implementation in clinical practice. Although some studies provide preliminary evidence of their diagnostic and prognostic potential, the use of these makers has not yet been implemented in clinical practice. The added value of RNAs to improve treatment and outcome remains to be determined in larger clinical studies. International consortia are now catalyzing renewed efforts to investigate novel RNAs that may improve post-MI outcome in a precision-medicine approach. Graphical Abstract Peripheral blood RNAs reflect the inflammatory changes in acute MI. A number of studies provide preliminary evidence of their prognostic potential, although the use of these makers has not yet been assessed in clinical practice.
过去几十年,急性心肌梗死(MI)患者的治疗和早期预后有了显著改善,但 MI 后左心室(LV)功能障碍的发生率仍然很高。外周血 RNA 反映了急性 MI 期间的病理生理变化和炎症过程。因此,这些 RNA 是有前途的新型标志物,可用于对患者进行分子表型分析,并有助于早期识别随后发生 LV 功能障碍的高危患者。我们在这里讨论了可以在外周血中测量的编码 RNA 和长非编码 RNA,并列出了将其应用于临床实践的优缺点。尽管一些研究提供了这些标志物在诊断和预后方面的初步证据,但它们尚未在临床实践中应用。在更大的临床研究中,仍需确定这些 RNA 对改善治疗和预后的附加价值。国际研究团体现在正在推动新的努力,以研究可能通过精准医疗方法改善 MI 后结局的新型 RNA。