Early detection value of miR-29a in patients with acute myocardial infarction

Background: Early detection of myocardial remodeling, a critical precursor to heart failure in acute myocardial infarction (AMI), remains inadequate with current biomarkers. Preclinical studies suggest miR-29a plays a role in these processes, yet its diagnostic value in early AMI remains unclear. This study evaluates the diagnostic and prognostic potential of miR-29a as a marker for myocardial remodeling in AMI patients. Methods: A prospective cohort study enrolled 52 patients with ST-elevation myocardial infarction (STEMI) caused by anterior descending branch occlusion, who underwent primary percutaneous coronary intervention within 12 h of symptom onset, along with 39 healthy controls. Results: Serum miR-29a levels were significantly elevated in STEMI patients compared to controls, exhibiting a graded increase with higher SYNTAX scores. MiR-29a levels positively correlated with soluble suppression of tumorigenicity 2 (sST2), N-terminal pro-brain natriuretic peptide (NT-proBNP), and the Tei index, while showing an inverse correlation with left ventricular ejection fraction (LVEF). Receiver operating characteristic (ROC) analysis indicated that serum miR-29a holds promise as a novel biomarker for early detection of myocardial remodeling in AMI. Furthermore, the combination of miR-29a with NT-proBNP and/or sST2 significantly enhanced diagnostic accuracy compared to individual biomarkers. The triad of miR-29a, NT-proBNP, and sST2 achieved the highest area under the curve (AUC) of 0.904, with 97.4% specificity and 76.9% sensitivity. Conclusion: Serum miR-29a shows significant potential as a biomarker for the early detection of myocardial remodeling in AMI, providing valuable diagnostic and prognostic insights.