Abstract
We sought to analyse plasma levels of peripheral blood microRNAs (miRs) as biomarkers of ST-segment-elevation myocardial infarction (STEMI) due to type-1 myocardial infarction as a model situation of vulnerable plaque (VP) rupture. Samples of 20 patients with STEMI were compared both with a group of patients without angina pectoris in whom coronary angiogram did not reveal coronary atherosclerotic disease (no coronary atherosclerosis-NCA) and a group of patients with stable angina pectoris and at least one significant coronary artery stenosis (stable coronary artery disease-SCAD). This study design allowed us to identify miRs deregulated in the setting of acute coronary artery occlusion due to VP rupture. Based on an initial large scale miR assay screening, we selected a total of 12 miRs (three study miRs and nine controls) that were tested in the study. Two of the study miRs (miR-331 and miR-151-3p) significantly distinguished STEMI patients from the control groups, while ROC analysis confirmed their suitability as biomarkers. Importantly, this was observed in patients presenting early with STEMI, even before the markers of myocardial necrosis (cardiac troponin I, miR-208 and miR-499) were elevated, which suggests that the origin of miR-331 and miR-151-3p might be in the VP. In conclusion, the study provides two novel biomarkers observed in STEMI, which may be associated with plaque rupture.
Highlights
Rupture of a vulnerable atherosclerotic plaque (VP), which leads to acute artery occlusion due to an overlying thrombosis, is a potentially devastating situation resulting in acute coronary syndromes (ACS), ischaemic stroke and other acute complications of atherosclerosis[1,2,3,4,5]
All segment-elevation myocardial infarction (STEMI) patients as well as all patients with SCAD were treated with a percutaneous coronary intervention (PCI)
The receiver operating characteristic (ROC) analysis confirmed the suitability of miR-331 as a biomarker (STEMI vs. NCA: area under the curve (AUC) = 0.790 [95% confidence intervals (CI); 0.649–0.931], p = 0.002; STEMI vs. SCAD: AUC = 0.773 [95% CI; 0.625–0.921], p = 0.003) (Fig. 2A)
Summary
Rupture of a vulnerable atherosclerotic plaque (VP), which leads to acute artery occlusion due to an overlying thrombosis, is a potentially devastating situation resulting in acute coronary syndromes (ACS), ischaemic stroke and other acute complications of atherosclerosis[1,2,3,4,5]. The molecules are very stable, easy to detect with quantitative polymerase chain reaction (qPCR) and are relatively tissue specific[9,10,11,12] Due to these properties, miRs appear to be very suitable biomarkers. The aim of this study was to identify plasma miRs from peripheral blood samples of patients with ST-segment-elevation myocardial infarction (STEMI) that might help quicken its diagnostics or may even be used directly as markers of VP. Such biomarkers might be used for the risk stratification of patients and both aid in tailoring the primary preventive measures and help as prognostic markers in patients with clinically manifested atherosclerosis
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