October 20, 2025Thrombosis Research2 citationsOpen Access
MicroRNA dynamics and their link to platelet function following acute ST-segment elevation myocardial infarction
Key Result
In STEMI patients, seven microRNAs were differentially expressed at 2-3 months compared to baseline, and several correlated with platelet function (e.g., miR-26b-5p rho 0.29-0.32, p<0.05).
Study Design
Type
Observational (n=44)
Structured PICO
Are changes in microRNA expression associated with platelet function and antiplatelet therapy efficacy in patients with acute STEMI?
P
Population
44 patients admitted with acute STEMI for primary percutaneous coronary intervention, followed for 2-3 months.
E
Exposure
Guideline-directed therapy for STEMI including antiplatelet therapy
O
Outcome
Changes in candidate miR expression from baseline (within 24 h) to follow-up (2-3 months) and their association with platelet reactivity markerssurrogate
Multiple microRNAs show dynamic expression changes following STEMI and correlate with platelet function, suggesting complex regulatory mechanisms rather than a single biomarker for antiplatelet efficacy.
Abstract
Background Reduced effect of antiplatelet therapy has been observed in patients with ST-segment elevation myocardial infarction (STEMI). MicroRNA (miR) expression may serve as biomarkers for platelet function and the effect of antiplatelet therapy. Aim In acute STEMI patients, we investigated changes in miR expression from the acute event to a more stable phase, and evaluated their association with platelet function at both time points to assess their potential as biomarkers of antiplatelet therapy efficacy. Methods Patients admitted with acute STEMI for primary percutaneous coronary intervention were included and treated according to guidelines. Samples were collected within 24 h after admission and at 2–3 months after enrolment. Expression of candidate miRs, platelet reactivity markers evaluated by flow cytometry, platelet impedance aggregometry and serum thromboxane B 2 were measured at both time points. Results Samples were obtained in 44 STEMI patients. Two miRs (miR-15a-5p and miR-21-5p) showed lower, whereas five (miR-26b-5p, miR-126-3p, miR-150-5p, miR-223-3p and miR-423-5p) showed higher expression at follow-up than at baseline. At baseline, miR-26b-5p expression consistently correlated with the expression of the fibrinogen receptor on activated platelets, across different agonists (rho: from 0.29 to 0.32, p < 0.05). At follow-up, miR-93-5p expression was associated with platelet aggregation using various agonists (rho: from −0.39 to −0.47, p < 0.02). Conclusions Seven miRs were differentially expressed at follow-up compared to baseline. Several miRs were linked to platelet function at baseline and follow-up, suggesting that a single miR may not be sufficient as a biomarker for platelet function and the effect of antiplatelet therapy.