Sensitive miRNA markers for the detection and management of NSTEMI acute myocardial infarction patients

Abstract

miRNA is a potentially sensitive biomarker for NSTEMI AMI patients for disease detection and treatment monitoring. The sensitivities were comparable to cTnT for diagnostic accuracy and patients with sustained or higher levels were correlated to secondary complications.

The Diagnostic Value of Mir-133a in ST Elevation and Non-ST Elevation Myocardial Infarction: A Meta-Analysis

“…Further subgroup analysis was performed in order to determine whether the distinction between STEMI and NSTEMI might account for some of the conflicting reports regarding increased Mir-133a concentrations following AMI. Relying on six papers that reported the percentage of STEMI patients in the study [17,18,20,21,24,37], and a linear regression model plotting Mir-133a fold as a function of this percentage, we found a moderate correlation (r = 0.49), with a trend of increasing Mir-133a concentration with higher percentages of STEMI patients ( Figure 3a). Furthermore, we compared subgroups from studies that reported data separately for STEMI or NSTEMI patients [17,18,20,21,24] and found a significantly higher value (p < 0.001) of the Mir-133a fold increase in STEMI patients vs. NSTEMI patients (11.6 ± 0.72 fold vs. 4.5 ± 0.14 fold, respectively; Figure 3b).…”

“…The remaining 23 eligible studies [10][11][12][16][17][18][19][20][21][22][24][25][26][27][28][29][30][31][32][33][34][35][36] were thoroughly analyzed and subjected to the above inclusion criteria ultimately yielding 9 studies (Table 1) involving 2280 participants, with 943 AMI patients and 1337 controls that were included in the quantitative meta-analysis. AMI-acute myocardial infarction; STEMI-ST elevation myocardial infarction; NSTEMI-non-ST elevation myocardial infarction; AUC-area under the curve.…”

“…The most consistently reported value in all the included studies was AUC. The combined frequency weighted analysis of this parameter yielded a pooled AUC of 0.73 (95% CI 0.68-0.79) for the eight studies [10,11,17,[19][20][21][22]24] in which a 95% confidence interval of the AUC was provided ( Figure 2). Cells 2020, 9, x FOR PEER REVIEW 7 of 16…”

“…Cells 2020, 9, Of the included studies, four [10,11,18,22] were controlled with non-AMI patients presenting with symptoms of acute coronary syndrome (ACS), four used healthy volunteers [19][20][21]24], and one used a mixed control population, with a majority of non-healthy recruits [17]. In order to assess whether choice of control partially explains the discrepancies in reported AUC values for Mir-133a in AMI, we compared these two groups using boxplots (Figure 4a).…”

“…This is most likely the result of damaged myocardium releasing Mir-133a during cellular lysis, or adjacent border zone myocardium releasing Mir-133a containing vesicles in response to the cardiac insult [16]. The research on Mir-133a's diagnostic potential, however, is strongly conflicted, with some papers reporting weak correlations between circulating Mir-133a concentrations and AMI [10,17], and others reporting strong correlations with excellent sensitivity and specificity [11,[18][19][20][21][22]. In light of these contradictory findings, this meta-analysis synthesizes data from existing literature in order to examine the true potential of Mir-133a as a biomarker in AMI.…”