Key result
A panel of circulating miR-19b, miR-223, and miR-483-5p improved early diagnosis of acute myocardial infarction, achieving an AUC of 0.92 in patients presenting within 3 hours of chest-pain onset.
Why the study?
Several microRNAs may be involved in coronary plaque rupture and local thrombus, but their diagnostic ability in acute myocardial infarction remains less known.
Does the measurement of circulating microRNAs improve the early diagnosis of acute myocardial infarction in patients presenting with acute chest pain?
Case-Control (n=280)
Does the measurement of circulating microRNAs improve the early diagnosis of acute myocardial infarction in patients presenting with acute chest pain?
Circulating miR-19b, miR-223, and miR-483-5p may serve as early diagnostic biomarkers for acute myocardial infarction, particularly in patients presenting within 3 hours of symptom onset or with initially negative troponin.
Answers are grounded in this paper and cite their sources.
MiRNA panel may aid early MI diagnosis; hypothesis-generating in case-control data and requires prospective validation before practice change.
BACKGROUND/AIMS: Evidence has shown that several microRNAs (miRNAs) may be involved in coronary plaque rupture and local thrombus. However, the diagnostic ability of these miRNAs in acute myocardial infarction (AMI) is less known. The aim of this study is to explore the diagnostic value of these circulating miRNAs in patients presenting with acute chest pain in the emergency department. METHODS AND RESULTS: In a nested case-control study, 140 of 1,206 patients finally diagnosed with AMI were matched with 70 unstable angina and 70 noncardiac chest pain patients. Five candidate miRNAs (miR-483-5p, miR-155-5p, miR-451, miR-19b, and miR-223) were selected for validation. Among them, miR-19b, miR-223, and miR-483-5p were significantly higher in AMI patients compared with those without AMI. A multivariate analysis showed that these miRNAs were independent predictors of AMI. The overall areas under the receiver operating curves (AUCs) for miR-19b, miR-223, and miR-483-5p were 0.74, 0.65, and 0.70, respectively. However, serial sampling in AMI patients showed that these miRNAs already peaked on admission, which was earlier than troponin I. Among 170 patients with a negative troponin result at presentation, a panel of three miRNAs improved the discrimination ability to a clinical model. In 119 patients presenting within 3 hr after chest-pain onset, the diagnostic accuracy of each miRNAs was higher than Point of care (POC) troponin assay. And a panel of these miRNAs had an AUC of 0.92. CONCLUSION: Circulating miR-19b, miR-223, and miR-483-5p may provide clinically useful information for diagnosis in the early phases of AMI.
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Li et al. (2019) conducted a case-control in Suspected acute myocardial infarction (n=280). Circulating miRNAs (miR-19b, miR-223, and miR-483-5p) vs. Patients without AMI (unstable angina and noncardiac chest pain) was evaluated on Diagnosis of acute myocardial infarction (AUC 0.74 for miR-19b, 0.65 for miR-223, and 0.70 for miR-483-5p). A panel of circulating miR-19b, miR-223, and miR-483-5p improved early diagnosis of acute myocardial infarction, achieving an AUC of 0.92 in patients presenting within 3 hours of chest-pain onset.
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