TY - JOUR
T1 - Prognostic and predictive microRNA panels for heart failure patients with reduced or preserved ejection fraction
T2 - a meta-analysis of Kaplan-Meier-based individual patient data
AU - Parvan, Reza
AU - Becker, Victoria
AU - Hosseinpour, Milad
AU - Moradi, Yousef
AU - Louch, William E
AU - Cataliotti, Alessandro
AU - Devaux, Yvan
AU - Frisk, Michael
AU - Silva, Gustavo Jose Justo
AU - AtheroNET COST Action CA21153
N1 - Funding:
Open access funding provided by University of Oslo (incl Oslo University Hos-
pital) This work is supported by the Norwegian Association for Public Health
(grant No. 19560 to G.J.J.S.; grant No. 16040 to M.F.) and by the Research Coun-
cil of Norway (grant No. 303150 to M.F.). Y.D. has received funding from the
EU Horizon 2020 project COVIRNA (grant agreement #101016072), the COST
Association (COST Actions CA17129 and CA21153), the National Research
Fund (grants #C14/BM/8225223, C17/BM/11613033, and COVID-19/2020–
1/14719577/miRCOVID), the Ministry of Higher Education and Research, and
the Heart Foundation-Daniel Wagner of Luxembourg. This article is based
upon work from COST Action AtheroNET, CA21153, supported by COST (Euro-
pean Cooperation in Science and Technology)
© 2025. The Author(s).
PY - 2025/7/7
Y1 - 2025/7/7
N2 - BACKGROUND: Cardiac troponins and natriuretic peptides are benchmark biomarkers for heart failure (HF) with reduced ejection fraction (HFrEF) but have limited prognostic performance for HF patients with preserved ejection fraction (HFpEF). Non-coding RNA-based biomarkers represent an innovative approach to risk-stratify patients and might address the unmet need for minimally invasive prognostic and predictive tools for HF development and HF-related outcomes. Our aim is to investigate the prognostic performance and risk stratification potential of circulating panels of microRNAs (miRNAs) in HFrEF and HFpEF.METHODS: A systematic search on PubMed, Web of Science, and Scopus databases was performed for studies reporting miRNAs as prognostic biomarkers in HF patients. A total of 22 studies pooling 5736 participants were included for quantitative analysis. KM-based individual patient data (IPD) analysis was performed in 12 studies (5064 participants).RESULTS: KM-based IPD analysis in HFrEF allowed the identification of a panel of four miRNAs (miR-27a-3p, miR-129-5p, miR-145-5p, and miR-590-3p) predicting the risk of all-cause death with hazard ratio (HR) 4.26 [2.68-6.76]. MiR-122-5p and miR-423-5p predicted cardiovascular death of HFrEF patients (HR 3.61 [2.67-4.87]). In HFpEF, miR-19a-3p predicted all-cause death of HFpEF patients with HR 2.23 [1.16-4.27]. Moreover, a panel of eight miRNAs (miR-17-5p, miR-20a-5p, miR-21, miR-23, miR-27, miR-106b-5p, miR-210, and miR-221) showed significant association with HF incidence (HR 2.14 [1.81-2.53]).CONCLUSIONS: A comprehensive meta-analysis of KM-based IPD enabled the identification of unique miRNA panels predicting the incidence and severity of HFrEF and HFpEF, supporting the clinical usefulness of miRNA profiling for tailored healthcare and risk stratification in HF patients. Nonetheless, more rigorously designed longitudinal studies are needed to validate the clinical application of miRNAs as prognostic and predictive biomarkers.
AB - BACKGROUND: Cardiac troponins and natriuretic peptides are benchmark biomarkers for heart failure (HF) with reduced ejection fraction (HFrEF) but have limited prognostic performance for HF patients with preserved ejection fraction (HFpEF). Non-coding RNA-based biomarkers represent an innovative approach to risk-stratify patients and might address the unmet need for minimally invasive prognostic and predictive tools for HF development and HF-related outcomes. Our aim is to investigate the prognostic performance and risk stratification potential of circulating panels of microRNAs (miRNAs) in HFrEF and HFpEF.METHODS: A systematic search on PubMed, Web of Science, and Scopus databases was performed for studies reporting miRNAs as prognostic biomarkers in HF patients. A total of 22 studies pooling 5736 participants were included for quantitative analysis. KM-based individual patient data (IPD) analysis was performed in 12 studies (5064 participants).RESULTS: KM-based IPD analysis in HFrEF allowed the identification of a panel of four miRNAs (miR-27a-3p, miR-129-5p, miR-145-5p, and miR-590-3p) predicting the risk of all-cause death with hazard ratio (HR) 4.26 [2.68-6.76]. MiR-122-5p and miR-423-5p predicted cardiovascular death of HFrEF patients (HR 3.61 [2.67-4.87]). In HFpEF, miR-19a-3p predicted all-cause death of HFpEF patients with HR 2.23 [1.16-4.27]. Moreover, a panel of eight miRNAs (miR-17-5p, miR-20a-5p, miR-21, miR-23, miR-27, miR-106b-5p, miR-210, and miR-221) showed significant association with HF incidence (HR 2.14 [1.81-2.53]).CONCLUSIONS: A comprehensive meta-analysis of KM-based IPD enabled the identification of unique miRNA panels predicting the incidence and severity of HFrEF and HFpEF, supporting the clinical usefulness of miRNA profiling for tailored healthcare and risk stratification in HF patients. Nonetheless, more rigorously designed longitudinal studies are needed to validate the clinical application of miRNAs as prognostic and predictive biomarkers.
KW - Humans
KW - Heart Failure/physiopathology
KW - Prognosis
KW - MicroRNAs/blood
KW - Stroke Volume/physiology
KW - Biomarkers/blood
KW - Kaplan-Meier Estimate
UR - https://pubmed.ncbi.nlm.nih.gov/40624658/
U2 - 10.1186/s12916-025-04238-0
DO - 10.1186/s12916-025-04238-0
M3 - Article
C2 - 40624658
SN - 1741-7015
VL - 23
JO - BMC Medicine
JF - BMC Medicine
IS - 1
M1 - 409
ER -