Objective Recent studies have revealed that microRNAs (miRNAs) are involved in the regulation of cardiac development, physiologic, and pathologic processes via post-transcriptional control of gene expression. The stable circulating miRNAs offer unique opportunities for the early diagnosis of several diseases. In this study, we examined the circulating miR-133 and miR-328 levels from patients with acute myocardial infarction (AMI). Patients and Methods Twenty-eight control subjects and fifty-one consecutive AMI patients were enrolled. The plasma and whole blood samples from AMI patients were obtained within 24 hours (n=51) and 7 days (n=6) after the onset of AMI symptoms. The circulating miR-133 and miR-328 levels were analyzed using quantitative real-time PCR. Results The miR-133 levels in plasma from AMI patients exhibited a 4.4-fold increase compared with control subjects (p=0.006). Moreover, the increased miR-133 levels in whole blood were comparable with those in plasma samples. In contrast, the miR-328 levels in plasma and whole blood of AMI patients were markedly increased by 10.9-fold and 16.1-fold, respectively, compared to those in control subjects (p=0.033 and p <0.001). The elevated circulating miR-133 and miR-328 levels were recovered to the control levels at 7 days after AMI. In addition, there was a correlation between circulating miR-133 or miR-328 levels and cardiac troponin I. Furthermore, circulating miR-133 or miR-328 showed no significant changes in AMI patients with tachyarrhythmia (n=24) or bradyarrhythmia (n=26) compared to those in patients without arrhythmias. Receiver operating characteristic curve analysis revealed that the areas under the curve of miR-133 or miR-328 in plasma and whole blood were 0.890, 0.702 and 0.810, 0.872, respectively (all p<0.05). Conclusion The miR-133 and miR-328 levels in plasma and whole blood in AMI patients were increased compared to those in control subjects. These miRNAs may represent novel biomarkers of AMI.

Ca2+ cycling plays a critical role in heart failure and lethal arrhythmias. As susceptibility to sudden cardiac death is considered to be a heritable trait in general population, we have therefore investigated whether potentially functional variants of genes encoding RyR2 (ryanodine receptor 2) and the L-type Ca2+ channel are related to the risk of ventricular arrhythmias and sudden cardiac death in CHF (chronic heart failure) in a case-control study. We found that the A allele of rs3766871 in RYR2 was associated with an increased risk of ventricular arrhythmias in patients with CHF {odds ratio, 1.66 [95% CI (confidence interval), 1.21-2.26]; P=0.002}. During a median follow-up period of 32 months in 1058 (85.0%) patients, 296 (28.0%) patients died from heart failure, of whom 141 (47.6%) had sudden cardiac death. After adjustment for age, gender and suspected risk factors, patients carrying the A allele of rs3766871 had an increased risk of cardiac death {HR (hazard ratio), 1.53 [95% CI, 1.11-2.12]; P=0.010} and sudden cardiac death [HR, 1.92 (95% CI, 1.25-2.94); P=0.003]. Patients carrying the A allele of rs790896 in RYR2 had a reduced risk of sudden cardiac death [HR, 0.65 (95% CI, 0.45-0.92); P=0.015]. In conclusion, the A allele of rs3766871 in RYR2 not only associates with ventricular arrhythmias, but also serves as an independent predictor of sudden cardiac death, and the A allele of rs790896 in RYR2 is a protective factor against sudden cardiac death in patients with CHF.

ObjectiveThis study aimed to investigate the effect of physicians’ characteristics and knowledge of LDL–C target goals on the quality of lipid management in China.MethodsA total of 25 317 dyslipidemia patients who had taken lipid–lowering medication for >3 months were enrolled in our study. Patients’ demographic data, medical history, lipid profile, their physician’s specialty and professional title and their hospital level as well as their LDL–C goal opinions were recorded.ResultsQuestionnaires were completed by 926 physicians with 6 different specialties and 4 professional statuses, in 3 different–level hospitals. Most (74.5%) of the physicians recognized the importance of considering LDL–C serum concentration for treating dyslipidemia, and set target LDL–C goals according to the 2007 Chinese guidelines for 83.4% of their patients. The LDL–C goal achievement rate was significantly higher for patients whose physicians’ knowledge of LDL–C target goals was consistent with guideline recommendations, compared with those whose physicians’ knowledge was inconsistent with the guidelines (60.4% vs 31.1%, P < 0.0001). Physicians working in tier 1 (odds ration (OR) = 2.95; 95% CI 2.37–3.67), (OR = 1.56; 95% CI 1.34–1.81) and tier 2 (OR = 2.53; 95% CI 2.22–2.88), (OR = 1.16; 95% CI 1.06–1.27) hospitals, specialized in neurology (OR = 1.13; 95% CI 0.93–1.36), (OR = 1.57; 95% CI 1.40–1.77), internal medicine (OR = 1.07; 95% CI 0.90–1.27), (OR = 1.58; 95% CI 1.39–1.80), endocrinology (OR = 1.02; 95% CI 0.87–1.21), (OR = 1.63; 95% CI 1.47–1.82) and being a resident vs attending physician (OR = 1.05; 95% CI 0.92–1.20), (OR = 1.00; 95% CI 1.00–1.19) were independent risk factors for low knowledge of LDL–C target goals and low LDL–C goal achievement.ConclusionChinese physicians’ characteristics and knowledge of LDL–C target goals were associated with patients’ LDL–C goal achievement.