miR-619-5p and cardiogenic shock in patients with ST-segment elevation myocardial infarction

Area of Science:

• Biochemistry
• Genetics
• Cardiology

Background:

• Cardiogenic shock (CS) is a severe complication of ST-segment elevation myocardial infarction (STEMI) with high mortality.
• Epigenetic factors in CS remain largely unexplored.
• This study investigates plasma microRNAs (miRNAs) in STEMI patients with and without CS.

Purpose of the Study:

• To identify plasma miRNA signatures associated with cardiogenic shock in STEMI patients.
• To evaluate the potential of these miRNAs as biomarkers for CS stratification and mortality prediction.
• To explore the role of epigenetic regulation in the severity of myocardial infarction.

Main Methods:

• Analysis of plasma miRNAs using microarray and RT-PCR in STEMI patients (n=49) stratified by CS presence.
• Validation of findings in an independent cohort of CS patients (n=35).
• In silico analysis to identify target genes of identified miRNAs.

Main Results:

• A 5-miRNA signature was identified, with miR-619-5p significantly elevated in CS patients (p=.003) and discriminating CS (AUC=.752).
• miR-619-5p levels correlated with risk scores (GRACE, CardShock) and predicted mortality in CS patients (AUCs > .73).
• In silico analysis suggested miR-619-5p and TNF-alpha are involved in inflammation, discriminating mortality in CS patients (HR=9.99).

Conclusions:

• Up-regulation of miR-619-5p in plasma is associated with cardiogenic shock and mortality in STEMI patients.
• miR-619-5p serves as a potential biomarker for CS and prognosis in STEMI.
• Epigenetic regulation of inflammation plays a specific role in myocardial infarction severity.