Abstract 17571: Prognostic Role of Soluble Micrornas in the Early Detection of High Platelet Reactivity and Periprocedural Myocardial Damage in Patients Undergoing Percutaneous Coronary Intervention
Introduction: Despite an optimal antiplatelet strategy, high residual platelet reactivity (HRPR) is associated with an increased risk of procedural myocardial infarction (PMI) in patients undergoing percutaneous coronary intervention (PCI). MicroRNAs (miR), small non-coding RNA molecules, play a significant role in vascular and platelet pathways by modulating several transcription factors. However, nowadays, few clinical studies has been conducted to evaluate the prognostic role of microRNAs in patients undergoing PCI.
Hypothesis: Thus, we aimed to analyze possible role of these molecules on platelet aggregation and PMI development in such patients.
Methods: To-date we enrolled 23 patients. Blood samples were collected for detection of cardiac markers (troponin I and creatine kinase-MB) and microRNAs extraction. RT-quantitative PCR was performed and relative quantification of miR expression calculated with the 2-ΔΔCt method. Platelet reactivity was measured by the VerifyNow P2Y12 assay and HRPR was defined as PRU>240. PMI was defined as an elevation of troponin >5 x 99th percentile upper reference limit occurring within 48 hours after PCI.
Results: A significant correlation was observed between mir-495, mir-301a and mir-346 and platelet reactivity (p<0.001, p=0.005 and p=0.014). Patients with HRPR had significantly higher levels of mir-495 and mir-301a
(p=0.001 and p=0.036). The ROC curve analysis confirmed the discriminatory power of high mir-495 levels in detecting patients with HRPR (AUC 0.904, p=0.002). Mir-495 and mir-21 were also over-expressed
in patients who developed PMI (p=0.032 and p=0.157). A significant correlation was found between post-procedural troponin values and miR-495 and miR-346. Logistic regression analysis identified high pre-PCI miR-495 levels as a positive predictor for PMI (OR=2.719, 95% CI 1.016-7.278; p=0.046), whereas, by ROC curve analysis as a discriminating factor between patients with and without PMI (AUC 0.767, p=0.039).
Conclusions: This study suggests that several microRNAs may influence molecular pathways leading to increased inflammation and platelet reactivity related to PMI, representing an useful tool for the early detection of patients at higher risk for this complication.
Author Disclosures: A. Nusca: None. D. Santovito: None. P. Marcantonio: None. V. De Nardis: None. S. Caroli: None. C. Paganelli: None. G. Di Sciascio: None. F. Cipollone: None.
- © 2014 by American Heart Association, Inc.