Expression of microRNA Predicts Cardiovascular Events in Patients with Stable Coronary Artery Disease

Background New biomarkers are warranted to identify patients with coronary artery disease (CAD) at high risk of recurrent cardiovascular events. It has been reported that the expression of microRNAs (miRs) may influence the development of CAD. Objectives We aimed to investigate whether the expression of selected candidate miRs is a predictor of cardiovascular events in a cohort of stable CAD patients.Methods We performed a single-center prospective study of 749 stable CAD patients with a median follow-up of 2.8 years. We investigated the expression of nine candidate miRs and their relation to cardiovascular events in this cohort. The primary endpoint was the composite of nonfatal myocardial infarction (MI), stent thrombosis (ST), ischemic stroke, and cardiovascular death. The composite of nonfatal MI and ST was analyzed as a secondary endpoint. Furthermore, nonfatal MI, ST, ischemic stroke, and all-cause mortality were analyzed as individual endpoints.Results Employing receiver operating characteristic curves, it was shown that compared with traditional cardiovascular risk factors alone, combining the expression of miR-223-3p with existing traditional cardiovascular risk factors increased the predictive value of ST (area under the curve: 0.88 vs. 0.77, p = 0.04), the primary composite endpoint (0.65 vs. 0.61, p = 0.049), and the secondary endpoint of the composite of nonfatal MI and ST (0.68 vs. 0.62, p = 0.04).Conclusions Among patients with CAD, adding miR-223-3p expression to traditional cardiovascular risk factors may improve prediction of cardiovascular events, particularly ST. Clinical trials confirming these findings are warranted.

Automated summary

This study aimed to investigate whether the expression of selected candidate miRNAs can predict cardiovascular events in stable CAD patients. Among 749 patients, adding miR-223-3p expression to traditional cardiovascular risk factors improved the predictive value of ST, the primary composite endpoint, and the secondary endpoint of the composite of nonfatal MI and ST. Clinical trials are needed to confirm these findings.