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Updated: Mar 29, 2026
Digital PCR for Quantifying Circulating MicroRNAs in Acute Myocardial Infarction and Cardiovascular Disease
Published on: July 3, 2018
MicroRNAs as Biomarkers of Short-Term Complications After Cardiac Surgery
Adam Kozik1, Kamila Konstancja Kowalewska1, Michał Piotrowski1
1CAROL-Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland.
Abstract:
Cardiac surgery carries substantial risk of early postoperative complications including postoperative atrial fibrillation (POAF, 30-50%), periprocedural myocardial infarction (PMI), acute kidney injury (AKI, 3.8-54.4%), bleeding (3-5%), stroke, and cognitive dysfunction. This narrative review synthesizes 30+ studies on circulating microRNAs (miRNAs) as perioperative biomarkers, identifying strongest evidence for cardiac-enriched miR-499 (AUC 0.93, sensitivity 85.7%, specificity 93.3%) and miR-133a (peaks 1-3 h post-declamping) in PMI diagnosis -outperforming troponins' 6h kinetics. POAF prediction favors preoperative miR-483-5p (AUC 0.78), while AKI, bleeding (miR-223), and neurological injury show emerging but less validated candidates (miR-21, miR-210-3p). We critically analyze limitations across studies and outline clinical translation barriers (3-6 h assay times, heparin inhibition, lacking standardization) with solutions for point-of-care implementation.
Insights
Circulating microRNAs show promise as biomarkers for predicting cardiac surgery complications like myocardial infarction and atrial fibrillation. Further research is needed to overcome clinical translation barriers for point-of-care use.
Area of Science:
- Biomarkers
- Cardiovascular Surgery
- Molecular Diagnostics
Background:
- Cardiac surgery involves significant risks of postoperative complications such as myocardial infarction, atrial fibrillation, and kidney injury.
- Current diagnostic methods have limitations in early detection and prediction of these adverse events.
Purpose of the Study:
- To review and synthesize evidence on circulating microRNAs (miRNAs) as perioperative biomarkers for cardiac surgery complications.
- To identify the most promising miRNA candidates and analyze barriers to clinical implementation.
Main Methods:
- Narrative review of over 30 studies investigating circulating miRNAs in the perioperative period.
- Analysis of diagnostic accuracy (AUC, sensitivity, specificity) for various miRNAs in predicting specific complications.
Main Results:
- Cardiac-enriched miR-499 and miR-133a show strong evidence for diagnosing periprocedural myocardial infarction, outperforming troponins.
- Preoperative miR-483-5p is promising for predicting postoperative atrial fibrillation.
- Emerging miRNA candidates exist for acute kidney injury and bleeding, requiring further validation.
Conclusions:
- Circulating miRNAs represent a novel class of biomarkers with potential for early detection and prediction of cardiac surgery complications.
- Standardization, assay time reduction, and overcoming heparin inhibition are key challenges for point-of-care implementation.
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