Journal
PLOS ONE
Volume 8, Issue 8, Pages -Publisher
PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0070644
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Funding
- Society for Research on Cardiovascular Diseases
- Ministry of Culture, Health and Higher Education
- National Fund for Research of Luxembourg
- NIHR Leicester Cardiovascular Biomedical Research Unit
- National Institute for Health Research [PDF-2011-04-051] Funding Source: researchfish
- National Institutes of Health Research (NIHR) [PDF-2011-04-051] Funding Source: National Institutes of Health Research (NIHR)
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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.
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