A panel of 4 microRNAs facilitates the prediction of left ventricular contractility after acute myocardial infarction

PLoS One. 2013 Aug 13;8(8):e70644. doi: 10.1371/journal.pone.0070644. eCollection 2013.

Abstract

Background: Prediction of clinical outcome after acute myocardial infarction (AMI) is challenging and would benefit from new biomarkers. We investigated the prognostic value of 4 circulating microRNAs (miRNAs) after AMI.

Methods: We enrolled 150 patients after AMI. Blood samples were obtained at discharge for determination of N-terminal pro-brain natriuretic peptide (Nt-proBNP) and levels of miR-16, miR-27a, miR-101 and miR-150. Patients were assessed by echocardiography at 6 months follow-up and the wall motion index score (WMIS) was used as an indicator of left ventricular (LV) contractility. We assessed the added predictive value of miRNAs against a multi-parameter clinical model including Nt-proBNP.

Results: Patients with anterior AMI and elevated Nt-proBNP levels at discharge from the hospital were at high risk of subsequent impaired LV contractility (follow-up WMIS>1.2, n = 71). A combination of the 4 miRNAs (miR-16/27a/101/150) improved the prediction of LV contractility based on clinical variables (P = 0.005). Patients with low levels of miR-150 (odds ratio [95% confidence interval] 0.08 [0.01-0.48]) or miR-101 (0.19 [0.04-0.97]) and elevated levels of miR-16 (15.9 [2.63-95.91]) or miR-27a (4.18 [1.36-12.83]) were at high risk of impaired LV contractility. The 4 miRNA panel reclassified a significant proportion of patients with a net reclassification improvement of 66% (P = 0.00005) and an integrated discrimination improvement of 0.08 (P = 0.001).

Conclusion: Our results indicate that panels of miRNAs may aid in prognostication of outcome after AMI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers
  • Female
  • Heart Ventricles / metabolism*
  • Heart Ventricles / physiopathology*
  • Humans
  • Male
  • MicroRNAs / blood
  • MicroRNAs / genetics*
  • Middle Aged
  • Models, Biological
  • Multivariate Analysis
  • Myocardial Contraction / genetics*
  • Myocardial Infarction / blood
  • Myocardial Infarction / genetics*
  • Myocardial Infarction / physiopathology*
  • Natriuretic Peptide, Brain / blood
  • Odds Ratio
  • Peptide Fragments / blood
  • Phenotype
  • Prognosis
  • Reproducibility of Results
  • Young Adult

Substances

  • Biomarkers
  • MicroRNAs
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain