Background Acute myocardial infarction (AMI) is a leading cause of death worldwide, occurring earlier and more severely in South Asian populations. Circulating microRNAs (miRNAs) are stable, non-invasive biomarkers with emerging diagnostic and prognostic potential, but population-specific data from South India remain limited. Methods In this prospective cohort, 216 participants were enrolled: 45 AMI patients, 71 stable coronary artery disease (CAD) patients, and 100 healthy controls. Plasma samples were collected within 24 h of symptom onset in AMI cases. Expression of prioritized circulating miRNAs ( n = 20) was quantified using qRT-PCR SYBR green chemistry using specific primers. Statistical analyses included hierarchical and k-means clustering, principal component analysis (PCA), pathway enrichment, and receiver operating characteristic (ROC) curve analyses. Results and conclusion MI patients showed significant upregulation of let-7b, let-7c-5p, miR-24-1, miR-342-3p, and miR-362-3p, and downregulation of miR-4485-3p, miR-494-3p, miR-939, and miR-4505 ( p 0.05). Cluster and PCA analyses revealed distinct segregation of AMI cases, while CAD exhibited intermediate molecular profiles. Pathway enrichment implicated ECM–receptor interaction, platelet activation, and PI3K/AKT signaling. ROC analysis demonstrated excellent discriminatory performance, with miR-4485-3p achieving an AUC of 1.000. There were no significant differences in the expression pattern of miR-3195, miR-6780b-5p between CAD and AMI patients. These findings highlight circulating miRNAs as promising biomarkers for AMI, reflecting key molecular processes of inflammation, apoptosis, and endothelial dysfunction.
Uppugunduri et al. (Thu,) studied this question.