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January 14, 2021Journal of the American Heart AssociationOpen Access

Low miR‐19b‐1‐5p Expression Is Related to Aspirin Resistance and Major Adverse Cardio‐ Cerebrovascular Events in Patients With Acute Coronary Syndrome

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Why the study?

Aspirin resistance increases recurrent event risk in ACS, but in vitro platelet function tests have limitations for detecting it, warranting investigation of miR-19b-1-5p as a potential biomarker.

Does low miR-19b-1-5p expression predict aspirin resistance and MACCE in patients with acute coronary syndrome?

Population

945 patients with ACS from multiple tertiary hospitals

Comparison

miR-19b-1-5p expression levels

Design

Multicenter cohort study

Follow-up

Mean 1.01±0.43 years

Authors

SSSandeep SinghIndiana University HealthMRMaurice W.J. de RondeAmsterdam University Medical CentersECEsther E. CreemersHeart Failure & Transplant

Discussion

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Implication

May identify aspirin-resistant ACS patients; leaves open prospective validation before clinical use.

Key Points

  • To evaluate whether miR-19b-1-5p expression can serve as a reliable biomarker for detecting aspirin resistance and predicting recurrent major adverse cardio-cerebrovascular events in patients with acute coronary syndrome.
  • Multicenter cohort study of patients with acute coronary syndrome (N=945) recruited from tertiary hospitals in New Zealand, Hong Kong, Malaysia, and Singapore between 2011 and 2015.
  • Quantified buffy coat miR-19b-1-5p expression via RT-qPCR and evaluated platelet reactivity using Multiplate aggregometry testing.
  • Monitored patients for major adverse cardio-cerebrovascular events over a mean follow-up duration of 1.01 ± 0.43 years.
  • Low miR-19b-1-5p expression was significantly associated with sustained platelet aggregation despite aspirin therapy (-Log-miR-19b-1-5p unstandardized beta: 44.50, 95% CI: 2.20–86.80, P < 0.05).
  • Lower miR-19b-1-5p expression independently predicted an increased risk of major adverse cardio-cerebrovascular events (-Log-miR-19b-1-5p HR: 1.85, 95% CI: 1.23–2.80, P < 0.05).
  • A significant interaction on event risk was observed between inverse miR-19b-1-5p expression and a family history of premature coronary artery disease (P = 0.01).

Structured PICO

Does low miR-19b-1-5p expression predict aspirin resistance and MACCE in patients with acute coronary syndrome?

P
Population
945 patients with acute coronary syndrome (ACS) enrolled from multiple tertiary hospitals in Christchurch, Hong Kong, Sarawak, and Singapore between 2011 and 2015.
I
Intervention
Low miR-19b-1-5p expression measured from buffy coat
C
Comparator
Higher miR-19b-1-5p expression
O
Outcome
Aspirin resistance (sustained platelet aggregation) and major adverse cardio-cerebrovascular events (MACCE)composite

Low miR-19b-1-5p expression may serve as a biomarker for aspirin resistance and predict recurrent MACCE in patients with acute coronary syndrome.

Cite This Study

Singh et al. (2021) studied this question.

synapsesocial.com/papers/6a73880630bc69be694e64f9https://doi.org/10.1161/jaha.120.017120

Topics

Dual antiplatelet therapy
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Also Consider

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  1. 1Platelet Content of Nitric Oxide Synthase 3 Phosphorylated At Serine1177 Is Associated with the Functional Response of Platelets to Aspirin2013 · 12 citations
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  5. 5Evidence for the inhibitory role of guanosine 3', 5'-monophosphate in ADP-induced human platelet aggregation in the presence of nitric oxide and related vasodilators1981 · 636 citations