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Digital PCR for Quantifying Circulating MicroRNAs in Acute Myocardial Infarction and Cardiovascular Disease
Published on: July 3, 2018
Evaluating Diagnostic and Prognostic Value of Plasma miRNA133a in Acute Chest Pain Patients Undergoing Coronary
Jia Ke-Gang1, Li Zhi-Wei, Zhang Xin
1From the Department of Clinical Laboratory (K-GJ, Z-WL, JW, PS, X-JH, H-XT, XT), Department of Surgery (X-CL), TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China; and Tianjin Second Hospital (XZ), Zhong Shan Road, HeBei District, Tianjin, China.
Abstract:
Circulating microRNA has recently emerged as a promising biomarker for cardiovascular disease. This study sought to evaluate the diagnostic and prognostic value of circulating miR-133a as a marker of acute myocardial infarction in acute chest pain patients undergoing coronary angiography.Plasma was collected from 312 patients with chest pain on admission in the emergency department and 67 healthy controls. MiR-133a was detected using real-time quantitative PCR and enhanced accu-TnI, creatinine kinase-MB mass, and myoglobin were measured by immunoassay. End-point events (serious adverse cardiovascular events which require hospitalization or cardiovascular death) were examined in the AMI (acute myocardical infarction) group within 1, 6, 12, and 24 months.The miR-133a level was higher in AMI patients than in non-AMI patients (P < 0.001). In the ROC analysis, the sensitivity of miR-133a in diagnosis of AMI is 0.61 and the specificity is 0.68. In the prognostic analysis, only 1 endpoint event was observed in the non-AMI group; the amount of cases with end-point events in the AMI group at 1,6,12, and 24 months were 8, 19, 28, and 35, respectively. The cutoff value of miR-133a was determined using the median value of the AMI group and separated the patients into a positive group and a negative group. The Kaplan-Meier survival curve showed no significant difference in survival was detected in AMI patients between the miR-133a positive group and negative group after follow-up (12-month: x2 = 1.353, P = 0.245; 24-month: x2 = 3.722, P = 0.054). After adjusting for age, gender, Killip classes, prior myocardiac infarction history, myoglobin, LVEF (left ventricular ejection fraction), diabetes, hypertension, smoking and systolic blood pressure, miR133a had a significant association with the risk of events at 12 months (HR = 2.869, P = 0.024) and 24 months (HR = 3.936, P = 0.001).In patients undergoing coronary angiography, circulating miR-133a is upregulated in AMI patients, but it does not provide enough accuracy for clinical AMI diagnosis because it also rises in unstable angina patients. Its prognostic value in AMI is uncertain mainly for the number of cases with end-point event was small and may be further validated in a larger, better designed study.
Insights
Circulating miR-133a is elevated in acute myocardial infarction (AMI) patients, but its diagnostic accuracy is limited. While not a definitive prognostic marker alone, miR-133a shows potential prognostic value in AMI after adjusting for clinical factors.
Area of Science:
- Biochemistry
- Molecular Biology
- Cardiology
Background:
- Circulating microRNAs (miRNAs) are emerging biomarkers for cardiovascular diseases.
- miR-133a has shown potential as a biomarker for acute myocardial infarction (AMI).
Purpose of the Study:
- To evaluate the diagnostic and prognostic value of circulating miR-133a in patients with acute chest pain undergoing coronary angiography.
- To assess miR-133a as a potential biomarker for AMI diagnosis and prognosis.
Main Methods:
- Plasma samples from 312 chest pain patients and 67 healthy controls were analyzed for miR-133a using real-time quantitative PCR.
- Standard cardiac biomarkers (accu-TnI, CK-MB, myoglobin) were measured.
- Cardiovascular events were tracked for 24 months in AMI patients.
Main Results:
- miR-133a levels were significantly higher in AMI patients compared to non-AMI patients (P < 0.001).
- ROC analysis showed miR-133a had a sensitivity of 0.61 and specificity of 0.68 for AMI diagnosis.
- Adjusted analysis revealed miR-133a was significantly associated with 12-month (HR=2.869, P=0.024) and 24-month (HR=3.936, P=0.001) event risk in AMI patients.
Conclusions:
- Circulating miR-133a is upregulated in AMI but lacks sufficient diagnostic accuracy due to elevation in unstable angina.
- The prognostic value of miR-133a in AMI is uncertain due to a small number of endpoint events, requiring further validation in larger studies.
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