Open AccessEarly assessment of acute coronary syndromes in the emergency department: the potential diagnostic value of circulating microRNAs
Author(s) -
Oerlemans Martinus I. F. J.,
Mosterd Arend,
Dekker Marieke S.,
de Vrey Evelyn A.,
van Mil Alain,
Pasterkamp Gerard,
Doevendans Pieter A.,
Hoes Arno W.,
Sluijter Joost P. G.
Publication year - 2012
Publication title -
embo molecular medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.923
H-Index - 107
eISSN - 1757-4684
pISSN - 1757-4676
DOI - 10.1002/emmm.201201749
Subject(s) - acute coronary syndrome , medicine , emergency department , troponin , biomarker , microrna , troponin i , prospective cohort study , troponin t , diagnostic biomarker , cardiology , diagnostic accuracy , myocardial infarction , biochemistry , chemistry , psychiatry , gene
Previous studies investigating the role of circulating microRNAs in acute coronary syndrome (ACS) were based on small patient numbers, performed no comparison with established markers of cardiac injury and did not have appropriate controls. We determined the potential diagnostic value of circulating microRNAs as novel early biomarkers in 332 suspected ACS patients on presentation to the emergency department (ED) in a prospective single‐centre study including cardiac miRNAs (miR‐1, ‐208a and ‐499), miR‐21 and miR‐146a. Levels of all miRs studied were significantly increased in 106 patients diagnosed with ACS, even in patients with initially negative high‐sensitive (hs) troponin or symptom onset <3 h. MiR‐1, miR‐499 and miR‐21 significantly increased the diagnostic value in all suspected ACS patients when added to hs‐troponin T (AUC 0.90). These three miRs were strong predictors of ACS independent of clinical co‐variates including patient history and cardiovascular risk factors. Interestingly, the combination of these three miRs resulted in a significantly higher AUC of 0.94 than hs‐troponin T (0.89). Circulating microRNAs hold great potential as novel early biomarkers for the management of suspected ACS patients.