Diagnostic and prognostic value of circulating microRNAs in patients with acute chest pain

Y. Devaux*, M. Mueller, P. Haaf, E. Goretti, R. Twerenbold, J. Zangrando, M. Vausort, T. Reichlin, K. Wildi, B. Moehring, D. R. Wagner, C. Mueller

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

101 Citations (Scopus)

Abstract

Objectives: To address the diagnostic value of circulating microRNAs (miRNAs) in patients presenting with acute chest pain. Design: In a prospective, international, multicentre study, six miRNAs (miR-133a, miR-208b, miR-223, miR-320a, miR-451 and miR-499) were simultaneously measured in a blinded fashion in 1155 unselected patients presenting with acute chest pain to the emergency department. The final diagnosis was adjudicated by two independent cardiologists. The clinical follow-up period was 2 years. Results: Acute myocardial infarction (AMI) was the adjudicated final diagnosis in 224 patients (19%). Levels of miR-208b, miR-499 and miR-320a were significantly higher in patients with AMI compared to those with other final diagnoses. MiR-208b provided the highest diagnostic accuracy for AMI (area under the receiver operating characteristic curve 0.76, 95% confidence interval 0.72-0.80). This diagnostic value was lower than that of the fourth-generation cardiac troponin T (cTnT; 0.84) or the high-sensitivity cTnT (hs-cTnT; 0.94; both P < 0.001 for comparison). None of the six miRNAs provided added diagnostic value when combined with cTnT or hs-cTnT (ns for the comparison of combinations vs. cTnT or hs-cTnT alone). During follow-up, 102 (9%) patients died. Levels of MiR-208b were higher in patients who died within 30 days, but the prognostic accuracy was low to moderate. None of the miRNAs predicted long-term mortality. Conclusion: The miRNAs investigated in this study do not seem to provide incremental diagnostic or prognostic value in patients presenting with suspected AMI.

Original languageEnglish
Pages (from-to)260-271
Number of pages12
JournalJournal of Internal Medicine
Volume277
Issue number2
DOIs
Publication statusPublished - 1 Feb 2015

Keywords

  • Acute myocardial infarction
  • Biomarker
  • Chest pain
  • Diagnosis
  • MicroRNAs
  • Prognosis

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