NFkB Interacting long non-coding RNA (NKILA) predicts major adverse cardiovascular events in the elderly

Introduction NF-κB Interacting long non-coding RNA (NKILA) regulates the translocation of the transcription factor NF-κB and inhibits its transcriptional action, with divergent effects on vascular function. However, its predictive utility in the elderly remains unknown. We hypothesize that NKILA could be a novel predictor of major adverse cardiovascular events (MACE) in elderly patients depending on background cardiovascular risk. Material and Methods A total of 300 individuals aged 75 years old, prospectively recruited in the Vienna Transdanube Aging (VITA) cohort, were included. Plasma was collected at enrolment. Circulating lncRNA was detected using real-time quantitative polymerase chain reaction. The primary endpoint was MACE, defined as a composite measure of coronary artery disease, non-fatal myocardial infarction or stroke, and peripheral artery disease over a 7.5-year follow-up. The association between circulating NKILA and incident MACE was analyzed by the Kaplan-Meier method. Predictive performance was assessed by the area under receiver-operator characteristic curve (AUC). Results Subjects with circulating levels of NKILA in the upper tertiles had a higher MACE incidence compared to those in the lowest tertile (I tertile vs II tertile p= 0.026; I tertile vs III tertile p= 0.032; OR for II/III tertile= 9.49; Figure 1). The association between NKILA and incident MACE was independent potential confounder (adjusted OR= 15.45, p= 0.034). In sensitivity analyses, the discriminatory performance of NKILA was better in those with a history of MACE compared to subjects with previous MACE (AUC= 0.616 vs AUC= 0.759; Figure 2). Conclusion NKILA predicts the incidence of MACE in elderly subjects, with a better performance in those at high background risk. Hence, NKILA is a potential epigenetic regulator of cardiovascular ageing and age related diseases. Independent studies are warranted to validate NKILA as a novel predictor of MACE in elderly subjects at high cardiovascular riskFigure 1 Figure 2