Abstract
Simple SummaryCoronary artery bypass graft (CABG) surgery is a procedure in which complex coronary arteries stenosis is treated by bypassing atherosclerotic lesions with venous or arterial grafts. CABG is associated with myocardial damage due to ischemia/reperfusion injury. In addition, postoperative complications, including perioperative myocardial infarction, atrial fibrillation and graft failure, remain important clinical challenges. So far, no reliable diagnostic and prognostic tools to predict outcomes after CABG surgery have been established. MiRNAs are noncoding, 21–24 nucleotide-long RNA particles, expressions of which alter during CABG surgery. Here, we summarize the potential clinical applicability of miRNAs as promising biomarkers to predict post-CABG procedure outcomes. MiRNAs are noncoding, 21–24 nucleotide-long RNA particles that control over 60% of genes. MiRNAs affect gene expression through binding to the 3’-untranslated region of messenger RNA (mRNA), thus inhibiting mRNA translation or inducing mRNA degradation. MiRNAs have been associated with various cardiovascular diseases, including heart failure, hypertension, left ventricular hypertrophy, or ischemic heart disease. In addition, miRNA expression alters during coronary artery bypass grafting (CABG) surgery, which could be used to predict perioperative outcomes. CABG is an operation in which complex coronary arteries stenosis is treated by bypassing atherosclerotic lesions with venous or arterial grafts. Despite a very low perioperative mortality rate and excellent long-term survival, CABG is associated with postoperative complications, including reperfusion injury, graft failure, atrial fibrillation and perioperative myocardial infarction. So far, no reliable diagnostic and prognostic tools to predict prognosis after CABG have been developed. Changes in the perioperative miRNA expression levels could improve the diagnosis of post-CABG myocardial infarction and atrial fibrillation and could be used to stratify risk after CABG. Herein, we describe the expression changes of different subtypes of miRNAs during CABG and review the diagnostic and prognostic utility of miRNAs in patients undergoing CABG.
Highlights
Coronary artery bypass grafting (CABG) is a surgical operation in which complex coronary arteries stenosis is treated by bypassing atherosclerotic lesions with venous or arterial grafts in patients with multivessel coronary artery disease (CAD), significant coronary artery stenosis [1] and complex coronary anatomy [2]
Impacting targeted messenger RNA (mRNA) expression and protein synthesis by up- and down-regulating miRNA seems to be an effective strategy in decreasing ischemia/reperfusion injury, preventing POAF and extending the recognition of patients who are at risk or have suffered from Perioperative myocardial infarction (PMI)
The studies related to our topic are already available; we underline the correlation between CABG surgery and ischemia/reperfusion injury (IRI) and highlight the problem of POAF in patients undergoing CABG surgery
Summary
Coronary artery bypass grafting (CABG) is a surgical operation in which complex coronary arteries stenosis is treated by bypassing atherosclerotic lesions with venous or arterial grafts in patients with multivessel coronary artery disease (CAD), significant coronary artery stenosis [1] and complex coronary anatomy [2]. MiRNAs seem to be a promising tool to predict post-CABG outcomes. We discuss the promising results regarding the utility of miRNA to alleviate post-CABG ischemia/reperfusion injury, inflammation and apoptosis by regulating the expression of particular miRNAs, including decreased expression of miR-195, miR-1 and miR-320 and overexpression of miR-7a/b, miR-144 and miR-133, all of which facilitate cell survival and protect from cell apoptosis. We discuss miRNA expression changes in patients undergoing CABG surgery, with a special focus on patients with perioperative atrial fibrillation (AF). MiR-483-5p presents significant preoperative overexpression in AF-naïve patients going on to develop post-CABG AF. It seems to be a promising biomarker, with a diagnostic accuracy of 78%. Biology 2021, 10, 1350 clinical application as biomarkers and therapeutic targets in perioperative myocardial infarction, post-CABG ischemia/reperfusion injury and post-CABG atrial fibrillation
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