A microRNA Signature for the Diagnosis of Statins Intolerance

Abstract

Atherosclerotic cardiovascular diseases (ASCVD) are the leading cause of morbidity and mortality in Western societies. Statins are the first-choice therapy for dislipidemias and are considered the cornerstone of ASCVD. Statin-associated muscle symptoms are the main reason for dropout of this treatment. There is an urgent need to identify new biomarkers with discriminative precision for diagnosing intolerance to statins (SI) in patients. MicroRNAs (miRNAs) have emerged as evolutionarily conserved molecules that serve as reliable biomarkers and regulators of multiple cellular events in cardiovascular diseases. In the current study, we evaluated plasma miRNAs as potential biomarkers to discriminate between the SI vs. non-statin intolerant (NSI) population. It is a multicenter, prospective, case-control study. A total of 179 differentially expressed circulating miRNAs were screened in two cardiovascular risk patient cohorts (high and very high risk): (i) NSI (n = 10); (ii) SI (n = 10). Ten miRNAs were identified as being overexpressed in plasma and validated in the plasma of NSI (n = 45) and SI (n = 39). Let-7c-5p, let-7d-5p, let-7f-5p, miR-376a-3p and miR-376c-3p were overexpressed in the plasma of SI patients. The receiver operating characteristic curve analysis supported the discriminative potential of the diagnosis. We propose a three-miRNA predictive fingerprint (let-7f, miR-376a-3p and miR-376c-3p) and several clinical variables (non-HDLc and years of dyslipidemia) for SI discrimination; this model achieves sensitivity, specificity and area under the receiver operating characteristic curve (AUC) of 83.67%, 88.57 and 89.10, respectively. In clinical practice, this set of miRNAs combined with clinical variables may discriminate between SI vs. NSI subjects. This multiparametric model may arise as a potential diagnostic biomarker with clinical value.

DNA and RNA Molecules as a Foundation of Therapy Strategies for Treatment of Cardiovascular Diseases

“…MiRNAs in circulation have been shown to indicate the status of thrombocytes in real time and that they can be used as biomarkers for the prediction of various aspects of their function, i.e., they can be used for monitoring and adjusting anti-aggregation therapy [ 46 , 47 ]. Additionally, it has been confirmed that miRNAs affect anticoagulation therapy with coumarin derivatives [ 48 ], therapy with direct anticoagulation drugs [ 49 ], and that they also affect therapy with statins, i.e., statin intolerance [ 50 ]. The predictive potential of long non-coding RNAs has also been recognised for the effects of anti-aggregation therapy [ 51 ].…”

Atherosclerosis and Other Related-Arterial Diseases

“…Therefore, it is important to distinguish patients with statin intolerance before they present muscle symptoms. Mangas et al [ 10 ] identified a new microRNA signature capable of discriminating between statin-intolerant and non-statin-intolerant patients. Moreover, when the authors add clinical information, such as years of dyslipidemia or non-high-density cholesterol levels, this set of circulating miRNAs significantly increases in accuracy.…”