Micro-RNA and the epicardial fat thickness in patients with coronary artery disease with coronary artery stenosis

Objective: To assess the levels of microRNAs (miRs) and the thickness of epicardial adipose tissue (EAT) in patients with ischemic heart disease (IHD) and borderline coronary artery stenosis (CAS). Material and methods. The study involved 201 patients with stable IHD of functional class (FC) 1–3, having borderline (50–70%) stenoses of the coronary arteries. The first group consisted of 57 (28.4%) patients with increased EAT thickness, while the second group included 144 (71.6%) patients without increased EAT thickness. The levels of the C-terminal fragment of pro-brain natriuretic peptide (NTproBNP) and miR levels (21m2, 133a, 208, 499a) were evaluated. EAT thickness was determined using echocardiography. All patients underwent coronary angiography. Results. The average EAT thickness in the first group was 6.00 [5.00; 6.50] mm, while in the second group it was 3.00 [2.30; 4.00] mm (p < 0.001). Patients in the first group developed arterial hypertension (p < 0.001), IHD (p < 0.001) in general, and myocardial infarction (p = 0.003) at a younger age. There were no significant differences between the groups regarding the prevalence of obesity, type 2 diabetes, angina FC, or the frequency of use of all four main groups of anti-ischemic drugs. A higher level of miR-208 (p = 0.001) and a greater frequency of increased NTproBNP levels (p = 0.002) were found in patients with increased EAT thickness. Conclusion. An elevated level of miR-208, a high frequency of increased NTproBNP, and a younger age at which cardiovascular diseases develop in patients with stable IHD and borderline CAS associated with increased EAT thickness may indicate a poorer prognosis, as they reflect the activity of cardiac remodeling.