Key result
A predictive model including circulating miR-1 at admission, clinical, and CMR factors showed greater predictive power for LV remodeling at 6 months than clinical and CMR factors alone (AUC 0.89 vs 0.81; P=0.034).
Why the study?
Identifying patients with a high likelihood of adverse left ventricular remodeling has critical implications for risk stratification after acute STEMI.
Does circulating miR-1 at admission predict left ventricular remodeling at 6 months in patients with first STEMI treated with primary PCI?
Observational (n=80)
Does circulating miR-1 at admission predict left ventricular remodeling at 6 months in patients with first STEMI treated with primary PCI?
Effect estimate: AUC 0.89 (95% CI 0.80-0.95)
p-value: p=0.034
Circulating miR-1 at admission provides incremental value over clinical and CMR measurements in predicting left ventricular remodeling 6 months after STEMI.
May augment post-MI remodeling prediction beyond clinical/CMR data; hypothesis-generating and requires prospective validation.
BACKGROUND: The identification of patients with a high likelihood of left ventricular (LV) remodeling with a high-risk prognosis has critical implications for risk stratification after acute ST-segment elevation myocardial infarction (STEMI). This study aimed to evaluate the relationship between circulating miR-1 and 6-month post-infarct LV remodeling based on cardiac magnetic resonance (CMR) imaging. METHODS: A total of 80 patients with a first STEMI treated with primary percutaneous coronary intervention (PCI) who underwent CMR imaging 1 week and 6 months after STEMI were evaluated. The percentage changes of LV ejection fraction (LVEF), LV end-diastolic volume (LVEDV), LV end-systolic volume index (LVESV) at 1 week and 6 months after PCI (%ΔLVEF, %ΔLVEDV and %ΔLVESV) were calculated. miR-1 was measured using polymerase chain reaction (PCR)-based technologies in plasma samples that were collected at admission. The study group was divided into two groups based on a 10% cutoff value for the percentage of change in the LV end-diastolic volume (%ΔLVEDV): remodeling at high risk of major adverse cardiac events (MACEs) (%ΔLVEDV ≥10%, termed the LV remodeling group) and remodeling at lower risk of MACEs (%ΔLVEDV <10%, termed the non-LV remodeling group). The associations of miR-1 expression with the %ΔLVEDV, percentage change in the LV end-systolic volume (%ΔLVESV), and percentage change in the LV ejection fraction at follow-up were estimated. RESULTS: , respectively; P=0.009 and P<0.001, respectively). The expression of miR-1 at admission was positively correlated with the %ΔLVEDV (r=0.611, P<0.001) and %ΔLVESV (r=0.268, P=0.016). Receiver operating characteristic (ROC) analysis showed that miR-1 expression predicted LV remodeling with an area under the curve (AUC) value of 0.68 (95% CI: 0.56-0.78). Compared with the clinical factors of peak creatine kinase-myocardial band (CK-MB) and peak troponin T level, peak logNT-proBNP showed the highest predictive power, with an AUC value of 0.75 (95% CI: 0.64-0.84). A model including the clinical, CMR, and miR-1 factors showed greater predictive power (P=0.034) than a model including only clinical and CMR factors, with AUCs of 0.89 (95% CI: 0.80-0.95) and 0.81 (95% CI: 0.71-0.89), respectively. CONCLUSIONS: Circulating miR-1 at admission is an independent predictor of LV remodeling 6 months after STEMI. miR-1 showed incremental value in predicting LV remodeling compared with the clinical and CMR measurements.
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Ma et al. (2020) conducted an observational in Acute ST-segment elevation myocardial infarction (STEMI) (n=80). Circulating miR-1 at admission vs. Clinical and CMR factors alone was evaluated on Left ventricular remodeling (%ΔLVEDV ≥10%) (AUC 0.89, 95% CI 0.80-0.95, p=0.034). A predictive model including circulating miR-1 at admission, clinical, and CMR factors showed greater predictive power for LV remodeling at 6 months than clinical and CMR factors alone (AUC 0.89 vs 0.81; P=0.034).
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