The role of acetylsalicylic acid and circulating microRNAs in primary prevention of cardiovascular events in patients with Diabetes Mellitus Type 2 – A Review

Abstract

Introduction. Type 2 diabetes mellitus (T2DM) is a common metabolic disorder, which carries a risk for atherosclerosis and cardiovascular impairment. The purpose of this review is to demonstrate the role of acetylsalicylic acid (ASA) in primary cardiovascular prevention in T2DM patients, as well as present an outline of microRNAs (miRNA) relevant to ASA therapy and should be evaluated as targets to improve treatment. Brief description of state of knowledge. Although the etiology of hypercoagulable state in T2DM is considered multifactorial, attention mainly focuses on platelet disturbances. Platelets in T2DM not only demonstrate intensified adhesion, activation, aggregation, and thrombin generation, but are likely to deliver miRNAs at specific sites of action in the cardiovascular system, hence contributing to the pathogenesis of cardiovascular events. Objective. Since cardiovascular disease (CVD) is currently the leading cause of mortality among T2DM patients, appropriate risk stratification and management is necessary to reduce morbidity and mortality in this group. A large number of T2DM patients show inadequate response to antiplatelet therapy, which currently revolves around ASA, despite compliance with treatment regimens proposed by the guidelines. Conclusions. The review shows that the use of ASA for primary prevention is beneficial in patients at high cardiovascular risk. However, it is important to select patients in whom ASA therapy will bring the most beneficial outcome with minimal risk for adverse effects. This can be potentially achieved with the use of unique biomarkers. The biologically diverse characteristics of miRNA make them a promising novel biomarker and potential tool for better risk stratification, as well as antiplatelet therapy optimization.

The Relation of the Brain-Derived Neurotrophic Factor with MicroRNAs in Neurodegenerative Diseases and Ischemic Stroke

“…MiRNAs play a crucial role in diverse biological and pathological processes in cardiovascular disease, diabetes, and neurological disorders and neurovascular disease. They are promising novel disease biomarkers and treatment approaches in cardiovascular diseases and diabetes as well as in neurodegenerative disease and ischemic stroke as they regulate gene expressions [11][12][13][14][15][16][17].…”

Long Non-Coding RNAs (lncRNAs) in Cardiovascular Disease Complication of Type 2 Diabetes

“…Non-coding RNAs (ncRNAs) are grouped into their sizes: (1) the small ncRNAs (size <200 bp) such as microRNA (miRNA) and some of the circular RNA (circRNA), and (2) the large ncRNAs such as long non-coding RNA (lncRNA) [13][14][15]. Among these ncRNAs, miRNA is most studied and comprehensively reviewed in T2D and CVD development [16][17][18], as well as being potential therapeutic targets [19][20][21]. In comparison, research on lncRNA and circRNA in T2D or CVD is still limited [22][23][24][25].…”