Abstract
BackgroundUntil recently, circulating micro-RNAs (miRNAs) have attracted major interest as novel biomarkers for the early diagnosis of coronary artery disease (CAD). This review article summarizes the available evidence on the correlation of micro-RNAs with both the clinical and subclinical coronary artery disease and highlights the necessity for exploring miRNAs as a potential diagnostic and prognostic biomarker of early CAD in an adult population.MethodsA systematic literature analysis and retrieval online systems Public/Publisher MEDLINE/ Excerpta Medica Database /Medical Literature Analysis and Retrieval System Online,(PUBMED/EMBASE/MEDLINE) search were conducted for relevant information. Search was limited to the articles published in English language and conducted on humans, January 2000 onwards. We excluded studies of heart surgery, coronary artery bypass grafting (CABG), angioplasty and heart transplant. Eighteen studies met the inclusion criteria.ResultsSeven out of 18 studies were multivariate, i.e. adjusted for age, gender, body mass index (BMI), smoking, hypertension, diabetes, and blood lipid profiles, while the remaining twelve studies were univariate analysis. Different sources of miRNAs were used, i.e. plasma/serum, microparticles, whole blood, platelets, blood mononuclear intimal and endothelial progenitor cells were investigated. Fourteen out of 18 studies showed up-regulation of different miRNA in CAD patients and in vulnerable plaque disease. Four out of 18 studies showed both the up-regulation and down-regulation of miRNA in the population, while only three studies showed down-regulation of miRNA. Various sources and types of miRNA were used in each study.ConclusionThis review gives an extensive overview of up-regulation and down-regulation of miRNA in CAD and non-CAD patients. The pattern of miRNA regulation with respect to CAD/non-CAD study subjects varies across individual studies and different parameters, which could be the possible reason for this aberrancy. We suggest further trials be conducted in future for highlighting the role of miRNA in CAD, which may improve both the diagnostic and therapeutic approaches to stratifying CAD burden in the general population.
Highlights
Heart disease is the leading cause of death for both males and females with more than half of the deaths reported in 2009 in males [1]
We suggest further trials be conducted in future for highlighting the role of miRNA in coronary artery disease (CAD), which may improve both the diagnostic and therapeutic approaches to stratifying CAD burden in the general population
A computerized search of the Public/Publisher MEDLINE/ Excerpta Medica Database /Medical Literature Analysis and Retrieval System Online/Excerpta Medica Database (PubMed/Medline/EMBASE) database was done with the keywords and medical subject headings (MESH) terms such as “micro ribonucleic acid (RNA),” “coronary artery disease,” “cardiovascular disease (CVD),” “Subclinical CVD,” “coronary artery calcium and micro RNA,” "miRNA and high sensitivity C- reactive protein,” “miRNA and coronary intimal thickness,” and “miRNA and pulse wave velocity.”
Summary
Heart disease is the leading cause of death for both males and females with more than half of the deaths reported in 2009 in males [1]. Coronary heart disease alone each year costs the United States $108.9 billion, which includes the cost of health care services, medications, and lost productivity [3]. Until recently, circulating micro-RNAs (miRNAs) have attracted major interest as novel biomarkers for the early diagnosis of coronary artery disease (CAD). This review article summarizes the available evidence on the correlation of micro-RNAs with both the clinical and subclinical coronary artery disease and highlights the necessity for exploring miRNAs as a potential diagnostic and prognostic biomarker of early CAD in an adult population.
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