Abstract 19348: A Panel of Free Circulating miRNAs (miR-1, miR-21, miR-133a, miR-208a and miR-499) May Be Used as Biomarkers to Discriminate Between Different Clinical Types of Coronary Artery Disease: Stable Coronary Artery Disease, Unstable Angina and Non-ST-Elevation Myocardial Infarction
Introduction: Some studies reported utility of microRNAs in ST-elevation myocardial infarction diagnosis, whereas their diagnostic value in non-ST elevation acute coronary syndrome (NSTE-ACS) still remains unclear.
Hypothesis: We hypothesized that the altered expression of 5 circulating miRs (miR-1, miR-21, miR-133a, miR-208a, miR-499) allows to differentiate NSTE-ACS from stable coronary artery disease (SCAD).
Methods: The prospective, single-center observational study was composed of 72 patients (pts) with NSTE-ACS with symptoms onset <24h before the hospital admission and 34 pts with SCAD as controls. Blood was sampled twice in the NSTE-ACS group (at admission and 4h after) and once in SCAD. Unstable angina (UA) vs NSTEMI diagnosis was based on the troponin 99th percentile rule. Relative expression of miRs were calculated using the ΔΔCt method after normalization to the cel-miR-39 spiked-in control. The mean value of miRs’ relative expression from two time samples in NSTE-ACS pts were used for further analysis.
Results: Free circulating miRs (except miR-21) levels were significantly elevated in NSTEMI: miR-1 6.5-fold (p<0.001), miR-133a 23.6-fold (p<0.001), miR-208a 4.0-fold (p=0.033) and miR-499 8.2-fold (p<0.001) as compared to SCAD. Moreover, miR-1 levels were increased 7.5-fold (p<0.001), miR-133a 5.8-fold (p=0.033) and miR-499 7.0-fold (p=0.003) when comparing NSTEMI to UA pts, and additionally two of them were able to discriminate between UA and SCAD patients: miR-133a (p=0.005) and miR-208a (p=0.035). Three of studied miRs were able to differentiate any NSTEMI individuals from other patients: miR-1 [area under the curve (AUC) 0.86, 95%CI 0.76-0.93, p<0.001], miR-133a (AUC 0.80, 95%CI 0.69-0.89, p<0.001) and miR-499 (AUC 0.77, 95%CI 0.65-0.86, p<0.001). MiR-1 elevation >12.2-fold yielded a sensitivity of 74.4% and specificity of 90.6%, miR-21 elevation >23.8-fold 74.4% and 84.4%, miR-499 elevation >4.7-fold 64.1% and 93.8% for distinguishing NSTEMI vs others.
Conclusions: The presented signature of circulating miRNAs differentiate not only NSTEMI patients from other individuals (miR-1, miR-208a, miR-133a, miR-499), but also NSTEMI from UA patients (miR-1, miR-133a, miR-499) and UA from SCAD (miR-133a and miR-208a).
Author Disclosures: D. Miskowiec: Research Grant; Significant; This study was supported by the Polish Ministry of Science and Higher Education. P. Lipiec: None. K. Kupczynska: None. M. Simiera: None. M. Ojrzanowski: None. B. Michalski: None. K. Wierzbowska-Drabik: None. P. Wejner-Mik: None. E. Szymczyk: None. J.D. Kasprzak: None.
- © 2016 by American Heart Association, Inc.