Long Li1, Sufang Li1, Manyan Wu1, Cheng Chi2, Dan Hu1, Yuxia Cui1, Junxian Song1, Chongyou Lee1, Hong Chen1. 1. Department of Cardiology, Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction, Center for Cardiovascular Translational Research, Peking University People's Hospital, Beijing, China. 2. Department of Emergency, Peking University People's Hospital, Beijing, China.
Abstract
BACKGROUND/AIMS: Evidence has shown that several microRNAs (miRNAs) may be involved in coronary plaque rupture and local thrombus. However, the diagnostic ability of these miRNAs in acute myocardial infarction (AMI) is less known. The aim of this study is to explore the diagnostic value of these circulating miRNAs in patients presenting with acute chest pain in the emergency department. METHODS AND RESULTS: In a nested case-control study, 140 of 1,206 patients finally diagnosed with AMI were matched with 70 unstable angina and 70 noncardiac chest pain patients. Five candidate miRNAs (miR-483-5p, miR-155-5p, miR-451, miR-19b, and miR-223) were selected for validation. Among them, miR-19b, miR-223, and miR-483-5p were significantly higher in AMI patients compared with those without AMI. A multivariate analysis showed that these miRNAs were independent predictors of AMI. The overall areas under the receiver operating curves (AUCs) for miR-19b, miR-223, and miR-483-5p were 0.74, 0.65, and 0.70, respectively. However, serial sampling in AMI patients showed that these miRNAs already peaked on admission, which was earlier than troponin I. Among 170 patients with a negative troponin result at presentation, a panel of three miRNAs improved the discrimination ability to a clinical model. In 119 patients presenting within 3 hr after chest-pain onset, the diagnostic accuracy of each miRNAs was higher than Point of care (POC) troponin assay. And a panel of these miRNAs had an AUC of 0.92. CONCLUSION: Circulating miR-19b, miR-223, and miR-483-5p may provide clinically useful information for diagnosis in the early phases of AMI.
BACKGROUND/AIMS: Evidence has shown that several microRNAs (miRNAs) may be involved in coronary plaque rupture and local thrombus. However, the diagnostic ability of these miRNAs in acute myocardial infarction (AMI) is less known. The aim of this study is to explore the diagnostic value of these circulating miRNAs in patients presenting with acute chest pain in the emergency department. METHODS AND RESULTS: In a nested case-control study, 140 of 1,206 patients finally diagnosed with AMI were matched with 70 unstable angina and 70 noncardiac chest painpatients. Five candidate miRNAs (miR-483-5p, miR-155-5p, miR-451, miR-19b, and miR-223) were selected for validation. Among them, miR-19b, miR-223, and miR-483-5p were significantly higher in AMI patients compared with those without AMI. A multivariate analysis showed that these miRNAs were independent predictors of AMI. The overall areas under the receiver operating curves (AUCs) for miR-19b, miR-223, and miR-483-5p were 0.74, 0.65, and 0.70, respectively. However, serial sampling in AMI patients showed that these miRNAs already peaked on admission, which was earlier than troponin I. Among 170 patients with a negative troponin result at presentation, a panel of three miRNAs improved the discrimination ability to a clinical model. In 119 patients presenting within 3 hr after chest-pain onset, the diagnostic accuracy of each miRNAs was higher than Point of care (POC) troponin assay. And a panel of these miRNAs had an AUC of 0.92. CONCLUSION: Circulating miR-19b, miR-223, and miR-483-5p may provide clinically useful information for diagnosis in the early phases of AMI.