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

J Intern Med. 2015 Feb;277(2):260-271. doi: 10.1111/joim.12183. Epub 2014 Mar 27.


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.

Keywords: acute myocardial infarction; biomarker; chest pain; diagnosis; microRNAs; prognosis.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Aged
  • Biomarkers / blood
  • Body Mass Index
  • Chest Pain / etiology*
  • Diagnosis, Differential
  • Early Diagnosis
  • Electrocardiography
  • Emergency Service, Hospital
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Luxembourg
  • Male
  • MicroRNAs / blood*
  • Middle Aged
  • Myocardial Infarction / blood
  • Myocardial Infarction / complications
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / mortality
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Sensitivity and Specificity
  • Switzerland
  • Troponin T / blood*


  • Biomarkers
  • MicroRNAs
  • Troponin T