Abstract 14954: Circulating Cardiospecific MicroRNAs are Associated with Long-term Prognosis Following Myocardial Infarction
Circulating microRNA (miRNA) has recently emerged as a promising biomarker for myocardial infarction. Apoptotic cardiomyocytes release miRNA into the circulation and the detection of cardiospecific miRNA species in the blood might constitute a rapid and robust diagnostic tool with high specificity. However, the studies conducted thus far have been based on small clinical materials and have exclusively looked at the acute phase of myocardial infarction (MI). We wanted to assess the usefulness of circulating miRNA both for distinguishing between MI and non-MI in the acute phase and for long term prognosis of death and development of heart failure in a larger population of acute coronary syndromes (ACS). All patients presenting with suspected ACS pain in the coronary care unit at Lund University Hospital were offered to take part in the study. Levels of cardiospecific miRNAs miR-1, miR-208b and miR-499 were measured in plasma of 430 patients by quantitative real time PCR. Receiver operator characteristic (ROC) analysis was performed to evaluate the ability of miRNA to distinguish between MI and non-MI. For assessing association of miRNA levels with long term prognosis, the primary endpoint was defined as development of heart failure or death within 30 days after hospitalization (n=74). Association of miRNA levels with the primary endpoint was tested by logistic regression. Correlation between miRNA levels and CKMB and left ventricular ejection fraction (LVEF) were also tested. All three miRNA correlated strongly with CKMB in the acute phase (p=0,01 for miR-1, 8*10^-41 for miR-208b and 1*10^-34 for miR-499). miR-208b and miR-499 could distinguish MI from non-MI ACS with high specificity and sensitivity in ROC analysis (AUC=0,82 and 0,79, respectively). All three miRNAs were significantly correlated with LVEF at discharge (p=0,04 for miR-1, 0,003 for miR-208b and 0,003 for miR-499). miR-208b and miR-499 were significantly associated with the primary endpoint, with an odds ratio of 1,8 (p=1*10^-5) and 1,7 (p=5*10^-5) per quartile. The results presented here suggest that early detection of circulating cardiospecific miR-208b and miR-499 could be useful as biomarkers both for diagnosis and long term prognosis of heart failure development and death following MI.
- © 2011 by American Heart Association, Inc.