Key result
Higher admission miR-223-3p expression is linked to ~43% lower odds of 48-hour residual congestion in ADHF.
Why the study?
MicroRNAs may provide information about decongestion in ADHF, prompting evaluation of their associations with residual congestion and diuretic treatment intensity.
Are admission circulating microRNAs (such as miR-223-3p and miR-423-5p) associated with residual congestion at 48 hours and diuretic treatment intensity in very elderly patients with acute decompensated heart failure?
Observational (n=145)
Are admission circulating microRNAs (such as miR-223-3p and miR-423-5p) associated with residual congestion at 48 hours and diuretic treatment intensity in very elderly patients with acute decompensated heart failure?
Admission circulating miR-223-3p and miR-423-5p levels show exploratory associations with 48-hour residual congestion in very elderly patients with acute decompensated heart failure, though external validation is needed prior to clinical application.
MicroRNAs may provide information about decongestion in acute decompensated heart failure (ADHF). We examined associations with residual congestion and diuretic treatment intensity. In 145 adults with ADHF, seven admission serum miRNAs were quantified by RT-qPCR. Residual congestion at 48 h required at least 2 of: VExUS score ≥ 1, clinical congestion score ≥ 3, or NT-proBNP ratio ≥ 0.70. Logistic and robust log-linear models assessed residual congestion and intravenous loop-diuretic dose intensity. Residual congestion occurred in 69 patients (47.6%). In complete-case models (n = 119), higher miR-223-3p expression was associated with lower odds (adjusted OR, 0.57; 95% CI, 0.36-0.91), whereas higher miR-423-5p expression was associated with higher odds (adjusted OR, 1.54; 95% CI, 1.00-2.38). Neither was independently associated with diuretic dose intensity. miR-223-3p showed the more consistent exploratory association with early residual congestion; evidence for miR-423-5p was less robust. External validation is required before clinical use.
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Santamaría et al. (2026) conducted an observational in Acute decompensated heart failure (ADHF) (n=145). Admission serum microRNAs (miR-223-3p and miR-423-5p) vs. Lower expression levels (continuous exposure) was evaluated on Residual congestion at 48 hours (requiring ≥2 of: VExUS score ≥1, clinical congestion score ≥3, or NT-proBNP ratio ≥0.70) (OR 0.57, 95% CI 0.36-0.91). Higher admission miR-223-3p expression was associated with lower odds of 48-hour residual congestion in ADHF (adjusted OR 0.57; 95% CI 0.36-0.91).
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