Analysis of Circulating miR-1, miR-23a, and miR-26a in Atrial Fibrillation Patients Undergoing Coronary Bypass Artery Grafting Surgery

Abstract

Atrial fibrillation (AF) is the most common arrhythmia after cardiac surgery. From a pathophysiological point of view, a myriad of factors such as trauma, atrial dilation, ischemia, mechanical myopericarditis, autonomic imbalance, loss of connexins, AF nest remodeling, inflammation, sutures, and dysfunction caused by postextracorporeal circulation can contribute to postoperative atrial fibrillation (POAF) resulting in a longer hospital stay and consequently higher cost. Recent studies showed that short fragments of RNA, called microRNA (miRNA), can contribute to the development of several cardiovascular diseases, including AF. The aim of this study was to evaluate the levels of circulating miRNAs (miR-1, -23a, and -26a) that can be involved in POAF. Patients submitted to coronary artery bypass graft surgery were grouped in POAF (24 patients) and without POAF (24 patients). Results showed older age, longer clamp-time, and more days in the intensive care unit as well as a longer total hospital stay in the POAF group. Preoperative levels of circulating miRNAs were similar. Analysis of miRNAs revealed significantly lower circulating levels of miRNA-23a (P = 0.02) and -26a (P = 0.01) in the POAF group during the postoperative period. Receiver operating characteristic (ROC) analysis showed the area under the ROC curve of miR-23a and miR-26a for predicting FA was 0.63 (95% confidence interval [CI]: 0.51-0.74; P = 0.02) and 0.66 (95% CI: 0.55-0.77; P = 0.01), respectively. Our data suggests that circulating miRNA-23a and -26a may be involved in the underlying biology of postoperative AF development.

miRNAS in cardiovascular diseases: potential biomarkers, therapeutic targets and challenges

“…The risk of post-operative AF can be predicted from elevated serum levels of miR483 76 . Circulating miR-23a and miR-26a may be involved in the underlying biology of post-operative AF development 77 .…”

RNAs and Gene Expression Predicting Postoperative Atrial Fibrillation in Cardiac Surgery Patients Undergoing Coronary Artery Bypass Grafting

“…The expression of miRNA−26a was noted to be significantly reduced in atrial samples collected from patients and large animals (dogs) with AF as compared to without AF (control group) [67]. Thus, to further explore the key role of miRNA−26a and miRNA−23a) in predicting POAF risk development, Feldman et al reported a study to identify patients who developed POAF after undergoing CABG surgery and compared circulating blood levels of miRNA−23a and miRNA−26a between two groups (POAF, n = 24 vs. no-POAF, n = 24) at preoperative and postoperative time points [36]. They harvested peripheral venous blood preoperatively and 48 h after CABG surgery.…”

“…To date, the relationship between the function of miRNAs, circRNAs, and gene expressions with POAF risk development in CABG patients has not been thoroughly reviewed in published literature. In this narrative review, we report the available experimental evidence of several miRNAs such as miRNA-483-5p [34], miRNA-29a [35], miRNA-23a [36], miRNA-26a [36], miRNA-199a [16], miRNA-1 [37], and miRNA-133a [37], one circRNA: circRNA-025016 [38], and selected gene expressions such as mitochondrial DNA (mtDNA) [39,40], and other single nucleotide polymorphisms (SNPs) such as vesicular overexpressed in cancer-prosurvival protein 1 gene (VOPP1) [41], rs3740563 [42], rs10504554 [43], rs2249825 [44], rs4572292 [45], rs11198893 [45], rs10033464 [46,47], rs2200733 [46][47][48] and rs13143308 [48] used previously as potential elements predicting POAF risk following CABG surgery.…”

Role of miRNAs on the Pathophysiology of Cardiovascular Diseases

“…There is evidence that miR-23a and miR-26a could also predict post-operative AF, since their levels are reduced in the postoperative period of patients undergoing coronary bypass artery grafting surgery. 34 Reduced circulating levels of miR-126 is a potential biomarker of the development, progression and severity of AF and HF, according to a study conducted with patients with AF, HF or both. 35 Also, Gorem et al 36 showed reduced expression of miR-150 in both platelets and serum of patients with chronic systolic HF associated with AF, compared with individuals without AF.…”