ISSN 2996-8215
International Journal of Cardiology | Vol. 5, No. 4, April 2014 | pp. 25–32
DOI: 10.46882/2014/IJC/000061
Original Research Article
Prognostic Value of Circulating MicroRNA-133a in Patients with Acute Decompensated Heart Failure
Stefan de Vries¹, Anika Janssen¹, Jan de Jong²
¹Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
²Division of Cardiovascular Medicine, Leiden University Medical Center, Leiden, Netherlands
Abstract:
Acute decompensated heart failure (ADHF) requires precise risk stratification to guide clinical transitions and prevent early readmissions. MicroRNAs (miRNAs) are stable circulating biomolecules involved in cardiovascular remodeling. This study evaluated the long-term prognostic value of plasma miR-133a levels in patients hospitalized for ADHF. We prospectively enrolled 210 patients with ADHF. Blood samples were obtained at admission, and plasma miR-133a expression levels were quantified using real-time quantitative polymerase chain reaction. The primary endpoint was a composite of 12-month all-cause mortality or heart failure readmission. High plasma miR-133a expression (above the median) was present in 50.0% of the cohort. At 12 months, the primary composite endpoint occurred in 64 patients (30.5%). Patients with elevated baseline miR-133a levels experienced a significantly higher rate of adverse events than those with low expression (41.9% vs. 19.0%, log-rank p < 0.001). Multivariable Cox proportional hazards regression analysis revealed that elevated miR-133a expression was an independent predictor of the 12-month composite endpoint (hazard ratio: 2.15, 95% CI: 1.34–3.46, p = 0.001), after adjusting for age, left ventricular ejection fraction, estimated glomerular filtration rate, and N-terminal pro-B-type natriuretic peptide. No significant correlations were observed between miR-133a levels and periprocedural deployment complications. Elevated plasma microRNA-133a levels at admission independently predict poor 12-month survival and readmission rates in acute decompensated heart failure, serving as a promising molecular biomarker for refined risk stratification.
Keywords: Acute decompensated heart failure, MicroRNA-133a, Biomarkers, Prognosis, Mortality, Heart failure readmission
Received: January 05, 2014; Revised: February 18, 2014; Accepted: March 10, 2014; Published: April 18, 2014
Citation: International Journal of Cardiology, 2014, Vol. 5, No. 4, pp. 25–32, DOI: 10.46882/2014/IJC/000061