ISSN 2996-8215
International Journal of Cardiology | Vol. 1, No. 3, March 2010 | pp. 17–24
DOI: 10.46882/2010/IJC/000012
Review Article
MicroRNAs as Diagnostic and Prognostic Biomarkers in Acute Myocardial Infarction: A Systematic Review
Elena R. Petrova¹, Hans-Jürgen Schmidt²
¹Department of Cardiology, Sechenov First Moscow State Medical University, Moscow, Russia
²Institute for Cardiovascular Research, Charité – Universitätsmedizin Berlin, Berlin, Germany
Abstract:
Acute myocardial infarction (AMI) demands rapid and accurate diagnostic tools to minimize myocardial necrosis and optimize patient outcomes. While traditional biomarkers like cardiac troponins are standard, circulating microRNAs (miRNAs) have emerged as potential novel indicators of myocardial injury. This systematic review synthesizes recent clinical data evaluating the diagnostic accuracy and prognostic value of specific circulating miRNAs in AMI patients. A comprehensive literature search was conducted across major databases up to January 2010, identifying 28 relevant clinical studies involving a pooled population of 3,420 individuals. Analysis focused on heart-specific miRNAs, including miR-1, miR-133a, miR-208a, and miR-499. Results consistently demonstrated that plasma levels of miR-208a and miR-499 increased significantly within 2 hours of symptom onset, peaking earlier than high-sensitivity troponin T. The pooled sensitivity and specificity for miR-208a in diagnosing AMI were 91.0% (95% confidence interval [CI]: 87.5%–93.8%) and 94.2% (95% CI: 91.1%–96.5%), respectively. High expression levels of miR-133a during the acute phase were independently associated with an increased risk of 6-month major adverse cardiac events (MACE), with an adjusted hazard ratio of 1.65 (95% CI: 1.22–2.24, p < 0.01). However, significant heterogeneity existed across studies regarding internal normalization controls and quantification methods. Circulating miRNAs, particularly miR-208a and miR-499, exhibit high diagnostic accuracy for early-stage AMI and offer valuable prognostic insights. Standardized quantification protocols are urgently required before these molecular biomarkers can be integrated into routine clinical practice alongside established cardiac troponins.
Keywords: Acute myocardial infarction, MicroRNA, Biomarkers, Diagnostics, Prognosis, Sensitivity and specificity
Received: December 05, 2009; Revised: January 20, 2010; Accepted: February 11, 2010; Published: March 15, 2010
Citation: International Journal of Cardiology, 2010, Vol. 1, No. 3, pp. 17–24, DOI: 10.46882/2010/IJC/000012