"Diagnostic Potential of Micro RNA Panel for Coronary Artery Disease in Patients with Angina"

Abstract

Background: Diagnosis of the coronary artery disease (CAD) in patients with angina is a challenge in clinical settings without invasive coronary angiography. Our objective was to find out non-invasive molecular diagnosis by relative expression of micro-RNA (miRNA) panel for CAD in the patients with angina.Methods: Diagnostic accuracy study was conducted in tertiary care hospitals of Rawalpindi, Pakistan. A total of 113 subjects, consisting of 58 cases, and 55 controls presented with chest pain, negative for Troponins, and were having coronary artery stenosis >50%, and <50% on angiography, respectively. miRNA-21, miRNA-33a, miRNA-133a, miRNA-145, and miRNA-146a were analyzed in blood with applied biological material kit protocol of Canada by polymerase chain reaction on Rotor-Gene. Results:In patients of CAD, relative expression of miRNA-33a, miRNA-133a, and miRNA-146a were significantly (P<0.05) up-regulated, while miRNA-21, and miRNA-145 were non-significant in comparison to controls. Receiver operating characteristic (ROC) curve analysis showed significantly (P<0.05) high area under curve (AUC), (95% CI) along with sensitivity and specificity of miRNA-33a 0.89(0.83-0.94), 86% & 78%; miRNA-133a 0.68(0.59-0.78), 60% & 53%, and miRNA-146a 0.79(0.70-0.87), 74% & 62%, respectively. CombiROC analysis of miRNA-33a, miRNA-133a, and miRNA-146a correctly identified CAD patients with angina (AUC=0.93, sensitivity 82%, specificity 90%). Significantly (P<0.05) positive correlation was seen for miRNA-33a (r=0.59), miRNA-133a (r=0.36), and miRNA-146a (r=0.37) with severity of CAD. Conclusion:The panel of miRNA (miRNA-33a, miRNA-133a, and miRNA-146a) can be utilized as noninvasive diagnostic biochemical marker for differentiating CAD patients from healthy individuals.