Abstract
BackgroundRecent studies indicated that microRNAs (miRNAs, miRs) were important for many biological and pathological processes, and they might be potential biomarkers for cardiovascular diseases. The present study aims to determine the release patterns of miRNAs in cardiac surgery and to analyze the ability of miRs to provide early prediction of perioperative myocardial infarction (PMI) in patients undergoing coronary artery bypass graft (CABG) surgery.Methodology/Principal FindingsThirty on-pump CABG patients were recruited in this study; and miR-499, miR-133a and miR-133b, cardiac troponin I (cTnI) were selected for measurement. Serial plasma samples were collected at seven perioperative time points (preoperatively, and 1, 3, 6, 12, 24, and 48 hours after declamping) and were tested for cTnI and miRs levels. Importantly, miR levels peaked as early as 1–3 hours, whereas cTnI levels peaked at 6 hours after declamping. Peak plasma concentrations of miRs correlated significantly with cTnI (miR-499, r = 0.583, P = 0.001; miR-133a, r = 0.514, P = 0.006; miR-133b, r = 0.437, P = 0.05), indicating the degree of myocardial damage. In addition, 30 off-pump CABG patients were recruited; miR-499 and miR-133a levels were tested, which were significantly lower in off-pump group than in on-pump group. A prospective cohort of CABG patients (n = 120) was recruited to study the predictive power of miRs for PMI. The diagnosis of PMI strictly adhered to the principles of universal definition of myocardial infarction. The data analysis revealed that miR-499 had higher sensitivity and specificity than cTnI, and indicated that miR-499 could be an independent risk factor for PMI.ConclusionOur results demonstrate that circulating miR-499 is a novel, early biomarker for identifying perioperative myocardial infarction in cardiac surgery.
Highlights
Perioperative myocardial infarction (PMI), as the most common cause of serious complications, occurs in 3% to 21% of patients undergoing surgery for coronary heart disease, leads to great postoperative morbidity and mortality and results in a considerable impact on the length and cost of hospitalization [1,2]
Our results demonstrate that circulating miR-499 is a novel, early biomarker for identifying perioperative myocardial infarction in cardiac surgery
Monitoring of the increase of cardiac troponin I level has helped to improve the diagnosis of perioperative myocardial infarction (PMI) at 24 to 48 hours of surgery [1], an earlier diagnosis that potentially further reduces the mortality rate is still desirable
Summary
Perioperative myocardial infarction (PMI), as the most common cause of serious complications, occurs in 3% to 21% of patients undergoing surgery for coronary heart disease, leads to great postoperative morbidity and mortality and results in a considerable impact on the length and cost of hospitalization [1,2]. Monitoring of the increase of cardiac troponin I (cTnI) level has helped to improve the diagnosis of PMI at 24 to 48 hours of surgery [1], an earlier diagnosis that potentially further reduces the mortality rate is still desirable. The present study aims to determine the release patterns of miRNAs in cardiac surgery and to analyze the ability of miRs to provide early prediction of perioperative myocardial infarction (PMI) in patients undergoing coronary artery bypass graft (CABG) surgery
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